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Chan JA, Bosma H, Lakerveld J, Schram MT, van Greevenbroek M, Koster A. Social cohesion and associations with sedentary time, physical activity and dietary quality in the Maastricht study. Prev Med 2024:107970. [PMID: 38653391 DOI: 10.1016/j.ypmed.2024.107970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 04/04/2024] [Accepted: 04/20/2024] [Indexed: 04/25/2024]
Abstract
INTRO We aim to investigate the relationship between social cohesion and sedentary behavior (SB), total physical activity (PA), moderate-to-vigorous PA (MVPA), and dietary quality. Additionally, we assess whether these associations are independent of neighborhood walkability and the food environment. METHODS A total of 7641 participants from The Maastricht Study in the Netherlands between the ages of 40 and 75 years were analyzed. Neighborhood social cohesion was obtained by participant questionnaire completed at baseline and measured by the Dutch Livability meter. Home addresses were linked to geographic information system (GIS) data from the Geoscience and Health Cohort Consortium (GECCO) to create neighborhood exposures of walkability and food environment. A thigh worn accelerometer collected data to measure sedentary time, total daily PA, and MVPA. Dietary quality was measured with a food frequency questionnaire. Multivariate linear regression analyses were adjusted for age, sex, socioeconomic position, neighborhood walkability, and food environment. RESULTS Those living in the highest quartile area of perceived social cohesion had statistically significant lower levels of SB (Q4 B: -13.04; 95% CI = -20.23, -5.85), higher total PA (Q4 B: 4.39; 95% CI = 1.69, 7.10), and higher MVPA (Q4 B: 2.57; 95% CI = 0.83, 4.31) and better diet quality (Q4 B: 1.12; 95% CI = 0.24, 2.01) compared to the lowest quartile independent of walkability and food environment. Similar results were found using the Livability meter. CONCLUSION We discovered neighborhood social cohesion as an important obesogenic determinant that should be considered in policymaking to encourage higher levels of PA and higher diet quality.
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Affiliation(s)
- Jeffrey Alexander Chan
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands; Department of Social Medicine, Maastricht University, Maastricht, the Netherlands; Department of Physical Medicine and Rehabilitation, Northern California VA Healthcare System, Martinez, CA, USA.
| | - Hans Bosma
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands; Department of Social Medicine, Maastricht University, Maastricht, the Netherlands
| | - Jeroen Lakerveld
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Miranda T Schram
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands; Department of Internal Medicine, Maastricht University, Maastricht, the Netherlands; Heart and Vascular Centre, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Marleen van Greevenbroek
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands; Department of Internal Medicine, Maastricht University, Maastricht, the Netherlands
| | - Annemarie Koster
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands; Department of Social Medicine, Maastricht University, Maastricht, the Netherlands
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van Gennip ACE, Gupta MD, Houben AJHM, Berendschot TTJM, Webers CAB, van Greevenbroek MMJ, van der Kallen CJH, Koster A, Wesselius A, Eussen SJPM, Schalkwijk CG, de Galan BE, Köhler S, Schram MT, Stehouwer CDA, van Sloten TT. Retinal microvascular function and incidence and trajectories of clinically relevant depressive symptoms: the Maastricht Study. Psychol Med 2024:1-10. [PMID: 38469703 DOI: 10.1017/s0033291724000618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
BACKGROUND Cerebral microvascular dysfunction may contribute to depression via disruption of brain structures involved in mood regulation, but evidence is limited. We investigated the association of retinal microvascular function, a proxy for microvascular function in the brain, with incidence and trajectories of clinically relevant depressive symptoms. METHODS Longitudinal data are from The Maastricht Study of 5952 participants (59.9 ± 8.5 years/49.7% women) without clinically relevant depressive symptoms at baseline (2010-2017). Central retinal arteriolar equivalent and central retinal venular equivalent (CRAE and CRVE) and a composite score of flicker light-induced retinal arteriolar and venular dilation were assessed at baseline. We assessed incidence and trajectories of clinically relevant depressive symptoms (9-item Patient Health Questionnaire score ⩾10). Trajectories included continuously low prevalence (low, n = 5225 [87.8%]); early increasing, then chronic high prevalence (early-chronic, n = 157 [2.6%]); low, then increasing prevalence (late-increasing, n = 247 [4.2%]); and remitting prevalence (remitting, n = 323 [5.4%]). RESULTS After a median follow-up of 7.0 years (range 1.0-11.0), 806 (13.5%) individuals had incident clinically relevant depressive symptoms. After full adjustment, a larger CRAE and CRVE were each associated with a lower risk of clinically relevant depressive symptoms (hazard ratios [HRs] per standard deviation [s.d.]: 0.89 [95% confidence interval (CI) 0.83-0.96] and 0.93 [0.86-0.99], respectively), while a lower flicker light-induced retinal dilation was associated with a higher risk of clinically relevant depressive symptoms (HR per s.d.: 1.10 [1.01-1.20]). Compared to the low trajectory, a larger CRAE was associated with lower odds of belonging to the early-chronic trajectory (OR: 0.83 [0.69-0.99]) and a lower flicker light-induced retinal dilation was associated with higher odds of belonging to the remitting trajectory (OR: 1.23 [1.07-1.43]). CONCLUSIONS These findings support the hypothesis that cerebral microvascular dysfunction contributes to the development of depressive symptoms.
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Affiliation(s)
- April C E van Gennip
- Internal Medicine, Maastricht University Medical Centre, Maastricht, Netherlands
- School for Cardiovascular Diseases, CARIM, Maastricht University, Maastricht, Netherlands
| | - Monideepa D Gupta
- Internal Medicine, Maastricht University Medical Centre, Maastricht, Netherlands
- School for Cardiovascular Diseases, CARIM, Maastricht University, Maastricht, Netherlands
| | - Alfons J H M Houben
- Internal Medicine, Maastricht University Medical Centre, Maastricht, Netherlands
- School for Cardiovascular Diseases, CARIM, Maastricht University, Maastricht, Netherlands
| | - Tos T J M Berendschot
- School for Mental Health and Neuroscience, MHENS, Maastricht University, Maastricht, Netherlands
- Ophthalmology, Maastricht University Medical Centre, Maastricht, Netherlands
- School of Nutrition and Translational Research in Metabolism, NUTRIM, Maastricht University, Maastricht, Netherlands
| | - Carroll A B Webers
- Ophthalmology, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Marleen M J van Greevenbroek
- Internal Medicine, Maastricht University Medical Centre, Maastricht, Netherlands
- School for Cardiovascular Diseases, CARIM, Maastricht University, Maastricht, Netherlands
| | - Carla J H van der Kallen
- Internal Medicine, Maastricht University Medical Centre, Maastricht, Netherlands
- School for Cardiovascular Diseases, CARIM, Maastricht University, Maastricht, Netherlands
| | - Annemarie Koster
- Care and Public Health Research Institute, CAPHRI, Maastricht University, Maastricht, Netherlands
- Social Medicine, Maastricht University, Maastricht, Netherlands
| | - Anke Wesselius
- School of Nutrition and Translational Research in Metabolism, NUTRIM, Maastricht University, Maastricht, Netherlands
- Genetics and Cell Biology, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Simone J P M Eussen
- School for Cardiovascular Diseases, CARIM, Maastricht University, Maastricht, Netherlands
- Care and Public Health Research Institute, CAPHRI, Maastricht University, Maastricht, Netherlands
- Epidemiology, Maastricht University, Maastricht, Netherlands
| | - Casper G Schalkwijk
- Internal Medicine, Maastricht University Medical Centre, Maastricht, Netherlands
- School for Cardiovascular Diseases, CARIM, Maastricht University, Maastricht, Netherlands
| | - Bastiaan E de Galan
- Internal Medicine, Maastricht University Medical Centre, Maastricht, Netherlands
- School for Cardiovascular Diseases, CARIM, Maastricht University, Maastricht, Netherlands
- Internal Medicine, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Sebastian Köhler
- School for Mental Health and Neuroscience, MHENS, Maastricht University, Maastricht, Netherlands
- Psychiatry and Neuropsychology, Maastricht University, Maastricht, Netherlands
| | - Miranda T Schram
- Internal Medicine, Maastricht University Medical Centre, Maastricht, Netherlands
- School for Cardiovascular Diseases, CARIM, Maastricht University, Maastricht, Netherlands
- School for Mental Health and Neuroscience, MHENS, Maastricht University, Maastricht, Netherlands
- Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Coen D A Stehouwer
- Internal Medicine, Maastricht University Medical Centre, Maastricht, Netherlands
- School for Cardiovascular Diseases, CARIM, Maastricht University, Maastricht, Netherlands
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Beran M, van Gennip ACE, Stehouwer CDA, Jansen JFA, Gupta MD, Houben AJHM, Berendschot TTJM, Webers CAB, Wesselius A, Schalkwijk CG, Backes WH, de Jong JJA, van der Kallen CJH, van Greevenbroek MMJ, Köhler S, Vonk JMJ, Geerlings MI, Schram MT, van Sloten TT. Microvascular Dysfunction and Whole-Brain White Matter Connectivity: The Maastricht Study. J Am Heart Assoc 2024; 13:e9112. [PMID: 38240213 DOI: 10.1161/jaha.123.031573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 11/16/2023] [Indexed: 02/07/2024]
Abstract
BACKGROUND Microvascular dysfunction is involved in the development of various cerebral disorders. It may contribute to these disorders by disrupting white matter tracts and altering brain connectivity, but evidence is scarce. We investigated the association between multiple biomarkers of microvascular function and whole-brain white matter connectivity. METHODS AND RESULTS Cross-sectional data from The Maastricht Study, a Dutch population-based cohort (n=4326; age, 59.4±8.6 years; 49.7% women). Measures of microvascular function included urinary albumin excretion, central retinal arteriolar and venular calibers, composite scores of flicker light-induced retinal arteriolar and venular dilation, and plasma biomarkers of endothelial dysfunction (intercellular adhesion molecule-1, vascular cell adhesion molecule-1, E-selectin, and von Willebrand factor). White matter connectivity was calculated from 3T diffusion magnetic resonance imaging to quantify the number (average node degree) and organization (characteristic path length, global efficiency, clustering coefficient, and local efficiency) of white matter connections. A higher plasma biomarkers of endothelial dysfunction composite score was associated with a longer characteristic path length (β per SD, 0.066 [95% CI, 0.017-0.114]) after adjustment for sociodemographic, lifestyle, and cardiovascular factors but not with any of the other white matter connectivity measures. After multiple comparison correction, this association was nonsignificant. None of the other microvascular function measures were associated with any of the connectivity measures. CONCLUSIONS These findings suggest that microvascular dysfunction as measured by indirect markers is not associated with whole-brain white matter connectivity.
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Affiliation(s)
- Magdalena Beran
- Department of Internal Medicine Maastricht University Medical Centre+ (MUMC+) Maastricht The Netherlands
- School for Cardiovascular Diseases CARIM Maastricht University Maastricht The Netherlands
- Department of Epidemiology and Global Health, Julius Center for Health Sciences and Primary Care University Medical Center Utrecht Utrecht The Netherlands
| | - April C E van Gennip
- Department of Internal Medicine Maastricht University Medical Centre+ (MUMC+) Maastricht The Netherlands
- School for Cardiovascular Diseases CARIM Maastricht University Maastricht The Netherlands
| | - Coen D A Stehouwer
- Department of Internal Medicine Maastricht University Medical Centre+ (MUMC+) Maastricht The Netherlands
- School for Cardiovascular Diseases CARIM Maastricht University Maastricht The Netherlands
| | - Jacobus F A Jansen
- School for Mental Health and Neuroscience (MHeNS) Maastricht University Maastricht The Netherlands
- Department of Radiology and Nuclear Medicine Maastricht University Medical Centre+ (MUMC+) Maastricht The Netherlands
- Department of Electrical Engineering Eindhoven University of Technology Eindhoven The Netherlands
| | - Monideepa D Gupta
- Department of Internal Medicine Maastricht University Medical Centre+ (MUMC+) Maastricht The Netherlands
- School for Cardiovascular Diseases CARIM Maastricht University Maastricht The Netherlands
| | - Alfons J H M Houben
- Department of Internal Medicine Maastricht University Medical Centre+ (MUMC+) Maastricht The Netherlands
- School for Cardiovascular Diseases CARIM Maastricht University Maastricht The Netherlands
| | - Tos T J M Berendschot
- School for Mental Health and Neuroscience (MHeNS) Maastricht University Maastricht The Netherlands
- Department of Ophthalmology Maastricht University Medical Centre (MUMC+) Maastricht The Netherlands
| | - Carroll A B Webers
- School for Mental Health and Neuroscience (MHeNS) Maastricht University Maastricht The Netherlands
- Department of Ophthalmology Maastricht University Medical Centre (MUMC+) Maastricht The Netherlands
| | - Anke Wesselius
- Department of Epidemiology Maastricht University Maastricht The Netherlands
| | - Casper G Schalkwijk
- Department of Internal Medicine Maastricht University Medical Centre+ (MUMC+) Maastricht The Netherlands
- School for Cardiovascular Diseases CARIM Maastricht University Maastricht The Netherlands
| | - Walter H Backes
- Department of Internal Medicine Maastricht University Medical Centre+ (MUMC+) Maastricht The Netherlands
- School for Cardiovascular Diseases CARIM Maastricht University Maastricht The Netherlands
- School for Mental Health and Neuroscience (MHeNS) Maastricht University Maastricht The Netherlands
| | - Joost J A de Jong
- School for Mental Health and Neuroscience (MHeNS) Maastricht University Maastricht The Netherlands
- Department of Radiology and Nuclear Medicine Maastricht University Medical Centre+ (MUMC+) Maastricht The Netherlands
| | - Carla J H van der Kallen
- Department of Internal Medicine Maastricht University Medical Centre+ (MUMC+) Maastricht The Netherlands
- School for Cardiovascular Diseases CARIM Maastricht University Maastricht The Netherlands
| | - Marleen M J van Greevenbroek
- Department of Internal Medicine Maastricht University Medical Centre+ (MUMC+) Maastricht The Netherlands
- School for Cardiovascular Diseases CARIM Maastricht University Maastricht The Netherlands
| | - Sebastian Köhler
- School for Mental Health and Neuroscience (MHeNS) Maastricht University Maastricht The Netherlands
- Alzheimer Centrum Limburg Maastricht University Medical Center+ (MUMC+) Maastricht The Netherlands
- Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine & Life Sciences Maastricht University Maastricht The Netherlands
| | - Jet M J Vonk
- Department of Epidemiology and Global Health, Julius Center for Health Sciences and Primary Care University Medical Center Utrecht Utrecht The Netherlands
- Memory and Aging Center, Department of Neurology University of California San Francisco San Francisco CA USA
| | - Mirjam I Geerlings
- Department of Epidemiology and Global Health, Julius Center for Health Sciences and Primary Care University Medical Center Utrecht Utrecht The Netherlands
- Department of General Practice Amsterdam UMC, University of Amsterdam Amsterdam The Netherlands
- Amsterdam Public Health, Aging & Later Life, and Personalized Medicine Amsterdam The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, and Mood, Anxiety, Psychosis, Stress, and Sleep Amsterdam The Netherlands
| | - Miranda T Schram
- Department of Internal Medicine Maastricht University Medical Centre+ (MUMC+) Maastricht The Netherlands
- School for Cardiovascular Diseases CARIM Maastricht University Maastricht The Netherlands
- School for Mental Health and Neuroscience (MHeNS) Maastricht University Maastricht The Netherlands
- Heart and Vascular Centre, Maastricht University Medical Centre Maastricht The Netherlands
| | - Thomas T van Sloten
- Department of Internal Medicine Maastricht University Medical Centre+ (MUMC+) Maastricht The Netherlands
- School for Cardiovascular Diseases CARIM Maastricht University Maastricht The Netherlands
- Department of Vascular Medicine University Medical Center Utrecht Utrecht The Netherlands
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Monereo-Sánchez J, Jansen JFA, van Boxtel MPJ, Backes WH, Köhler S, Stehouwer CDA, Linden DEJ, Schram MT. Association of hippocampal subfield volumes with prevalence, course and incidence of depressive symptoms: The Maastricht Study. Br J Psychiatry 2024; 224:66-73. [PMID: 37993980 PMCID: PMC10807974 DOI: 10.1192/bjp.2023.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 08/09/2023] [Accepted: 09/26/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND Late-life depression has been associated with volume changes of the hippocampus. However, little is known about its association with specific hippocampal subfields over time. AIMS We investigated whether hippocampal subfield volumes were associated with prevalence, course and incidence of depressive symptoms. METHOD We extracted 12 hippocampal subfield volumes per hemisphere with FreeSurfer v6.0 using T1-weighted and fluid-attenuated inversion recovery 3T magnetic resonance images. Depressive symptoms were assessed at baseline and annually over 7 years of follow-up (9-item Patient Health Questionnaire). We used negative binominal, logistic, and Cox regression analyses, corrected for multiple comparisons, and adjusted for demographic, cardiovascular and lifestyle factors. RESULTS A total of n = 4174 participants were included (mean age 60.0 years, s.d. = 8.6, 51.8% female). Larger right hippocampal fissure volume was associated with prevalent depressive symptoms (odds ratio (OR) = 1.26, 95% CI 1.08-1.48). Larger bilateral hippocampal fissure (OR = 1.37-1.40, 95% CI 1.14-1.71), larger right molecular layer (OR = 1.51, 95% CI 1.14-2.00) and smaller right cornu ammonis (CA)3 volumes (OR = 0.61, 95% CI 0.48-0.79) were associated with prevalent depressive symptoms with a chronic course. No associations of hippocampal subfield volumes with incident depressive symptoms were found. Yet, lower left hippocampal amygdala transition area (HATA) volume was associated with incident depressive symptoms with chronic course (hazard ratio = 0.70, 95% CI 0.55-0.89). CONCLUSIONS Differences in hippocampal fissure, molecular layer and CA volumes might co-occur or follow the onset of depressive symptoms, in particular with a chronic course. Smaller HATA was associated with an increased risk of incident (chronic) depression. Our results could capture a biological foundation for the development of chronic depressive symptoms, and stresses the need to discriminate subtypes of depression to unravel its biological underpinnings.
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Affiliation(s)
- Jennifer Monereo-Sánchez
- School for Mental Health & Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands; and Department of Radiology & Nuclear Medicine, Maastricht University Medical Center, the Netherlands
| | - Jacobus F. A. Jansen
- School for Mental Health & Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands; and Department of Radiology & Nuclear Medicine, Maastricht University Medical Center, the Netherlands
| | - Martin P. J. van Boxtel
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands
| | - Walter H. Backes
- School for Mental Health & Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands; Department of Radiology & Nuclear Medicine, Maastricht University Medical Center, the Netherlands; and School for Cardiovascular Diseases, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands
| | - Sebastian Köhler
- School for Mental Health & Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands; and Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, the Netherlands
| | - Coen D. A. Stehouwer
- School for Cardiovascular Diseases, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands; Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, the Netherlands; and Department of Internal Medicine, Maastricht University Medical Center, the Netherlands
| | - David E. J. Linden
- School for Mental Health & Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands
| | - Miranda T. Schram
- School for Mental Health & Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands; School for Cardiovascular Diseases, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands; Department of Internal Medicine, Maastricht University Medical Center, the Netherlands; and Maastricht Heart + Vascular Center, Maastricht University Medical Center, the Netherlands
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5
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de Jong JJA, Jansen JFA, Vergoossen LWM, Schram MT, Stehouwer CDA, Wildberger JE, Linden DEJ, Backes WH. Effect of Magnetic Resonance Image Quality on Structural and Functional Brain Connectivity: The Maastricht Study. Brain Sci 2024; 14:62. [PMID: 38248277 PMCID: PMC10813868 DOI: 10.3390/brainsci14010062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 12/27/2023] [Accepted: 01/04/2024] [Indexed: 01/23/2024] Open
Abstract
In population-based cohort studies, magnetic resonance imaging (MRI) is vital for examining brain structure and function. Advanced MRI techniques, such as diffusion-weighted MRI (dMRI) and resting-state functional MRI (rs-fMRI), provide insights into brain connectivity. However, biases in MRI data acquisition and processing can impact brain connectivity measures and their associations with demographic and clinical variables. This study, conducted with 5110 participants from The Maastricht Study, explored the relationship between brain connectivity and various image quality metrics (e.g., signal-to-noise ratio, head motion, and atlas-template mismatches) that were obtained from dMRI and rs-fMRI scans. Results revealed that in particular increased head motion (R2 up to 0.169, p < 0.001) and reduced signal-to-noise ratio (R2 up to 0.013, p < 0.001) negatively impacted structural and functional brain connectivity, respectively. These image quality metrics significantly affected associations of overall brain connectivity with age (up to -59%), sex (up to -25%), and body mass index (BMI) (up to +14%). Associations with diabetes status, educational level, history of cardiovascular disease, and white matter hyperintensities were generally less affected. This emphasizes the potential confounding effects of image quality in large population-based neuroimaging studies on brain connectivity and underscores the importance of accounting for it.
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Affiliation(s)
- Joost J. A. de Jong
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, 6202 AZ Maastricht, The Netherlands
- School for Mental Health and Neurosciences (MHeNs), Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Jacobus F. A. Jansen
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, 6202 AZ Maastricht, The Netherlands
- School for Mental Health and Neurosciences (MHeNs), Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Laura W. M. Vergoossen
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, 6202 AZ Maastricht, The Netherlands
- School for Mental Health and Neurosciences (MHeNs), Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Miranda T. Schram
- School for Mental Health and Neurosciences (MHeNs), Maastricht University, 6200 MD Maastricht, The Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre, 6202 AZ Maastricht, The Netherlands
- School for Cardiovascular Disease (CARIM), Maastricht University, 6200 MD Maastricht, The Netherlands
- Heart and Vascular Centre, Maastricht University Medical Centre, 6202 AZ Maastricht, The Netherlands
| | - Coen D. A. Stehouwer
- School for Mental Health and Neurosciences (MHeNs), Maastricht University, 6200 MD Maastricht, The Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre, 6202 AZ Maastricht, The Netherlands
- School for Cardiovascular Disease (CARIM), Maastricht University, 6200 MD Maastricht, The Netherlands
- Heart and Vascular Centre, Maastricht University Medical Centre, 6202 AZ Maastricht, The Netherlands
| | - Joachim E. Wildberger
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, 6202 AZ Maastricht, The Netherlands
- School for Cardiovascular Disease (CARIM), Maastricht University, 6200 MD Maastricht, The Netherlands
| | - David E. J. Linden
- School for Mental Health and Neurosciences (MHeNs), Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Walter H. Backes
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, 6202 AZ Maastricht, The Netherlands
- School for Mental Health and Neurosciences (MHeNs), Maastricht University, 6200 MD Maastricht, The Netherlands
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6
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Meisters R, Albers J, Sezer B, de Galan BE, Eussen SJPM, Stehouwer CDA, Schram MT, van Greevenbroek MMJ, Wesselius A, Koster A, Bosma H. Socioeconomic inequalities in health-related functioning among people with type 2 Diabetes: longitudinal analyses in the Maastricht Study. BMC Public Health 2024; 24:73. [PMID: 38172697 PMCID: PMC10763122 DOI: 10.1186/s12889-023-17553-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is a common chronic disease that disproportionally affects disadvantaged groups. People with a low socioeconomic position (SEP) have increased risk of T2DM and people with a low SEP and T2DM have higher HbA1c-levels compared to people with T2DM and high SEP. The aim of this study is to analyze longitudinal socioeconomic differences in health-related functioning in people with T2DM. METHODS Longitudinal data from 1,537 participants of The Maastricht Study with T2DM were used (32.6% female, mean (SD) age 62.9 (7.7) years). SEP was determined by baseline measures of education, occupation and income. Health-related functioning (physical, mental and social) was measured with the Short-Form Health Survey and the Impact on Participation and Autonomy survey (all scored from 0 to 100). Associations of SEP and health-related functioning were studied annually over a 10-year period (median (IQR) 7.0 (5.0) years, baseline 2010-2018) using linear mixed methods adjusting for demographics, HbA1c-levels and lifestyle factors. RESULTS Participants with a low SEP had significantly worse health-related functioning compared to those with a high SEP. For example, participants with low income had lower scores for physical (-4.49[CI -5.77;-3.21]), mental (-2.61[-3.78,-1.44]) and social functioning (-9.76[-12.30;-7.23]) compared to participants with high income on a scale from 0 to 100. In addition, participants with a low education significantly declined more over time in mental (score for interaction education with time - 0.23[-0.37;-0.09]) and social functioning (-0.44[-0.77;-0.11]) compared to participants with high education. Participants with low and intermediate incomes significantly declined more over time in physical functioning (-0.17 [-0.34, -0.01 and - 0.18 [-0.36, 0.00]) compared to participants with high income. CONCLUSIONS Among people with T2DM, those with a lower SEP had worse health-related functioning in general than people with a higher SEP. Additionally, people with T2DM and low education developed poorer mental and social functioning over time compared to people with T2DM and high education. People with T2DM and low or intermediate income declined more in physical functioning over time than those with high incomes. In addition to HbA1c-levels and lifestyle patterns, more attention is needed for socioeconomic differences in health-related functioning for people living with T2DM.
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Affiliation(s)
- Rachelle Meisters
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Duboisdomein 30, Maastricht, 6229 GT, the Netherlands.
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands.
| | - Jeroen Albers
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Duboisdomein 30, Maastricht, 6229 GT, the Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Bengisu Sezer
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Duboisdomein 30, Maastricht, 6229 GT, the Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Bastiaan E de Galan
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Simone J P M Eussen
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Epidemiology, Maastricht University, Maastricht, the Netherlands
| | - Coen D A Stehouwer
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Miranda T Schram
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- MHeNS School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
- Heart and Vascular Center, Maastricht University Medical Center (MUMC+), Maastricht, the Netherlands
| | | | - Anke Wesselius
- Department of Epidemiology, Maastricht University, Maastricht, the Netherlands
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, the Netherlands
| | - Annemarie Koster
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Duboisdomein 30, Maastricht, 6229 GT, the Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Hans Bosma
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Duboisdomein 30, Maastricht, 6229 GT, the Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
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7
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van der Heide FCT, Steens ILM, Limmen B, Mokhtar S, van Boxtel MPJ, Schram MT, Köhler S, Kroon AA, van der Kallen CJH, Dagnelie PC, van Dongen MCJM, Eussen SJPM, Berendschot TTJM, Webers CAB, van Greevenbroek MMJ, Koster A, van Sloten TT, Jansen JFA, Backes WH, Stehouwer CDA. Thinner inner retinal layers are associated with lower cognitive performance, lower brain volume, and altered white matter network structure-The Maastricht Study. Alzheimers Dement 2024; 20:316-329. [PMID: 37611119 PMCID: PMC10917009 DOI: 10.1002/alz.13442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 07/26/2023] [Accepted: 08/01/2023] [Indexed: 08/25/2023]
Abstract
INTRODUCTION The retina may provide non-invasive, scalable biomarkers for monitoring cerebral neurodegeneration. METHODS We used cross-sectional data from The Maastricht study (n = 3436; mean age 59.3 years; 48% men; and 21% with type 2 diabetes [the latter oversampled by design]). We evaluated associations of retinal nerve fiber layer, ganglion cell layer, and inner plexiform layer thicknesses with cognitive performance and magnetic resonance imaging indices (global grey and white matter volume, hippocampal volume, whole brain node degree, global efficiency, clustering coefficient, and local efficiency). RESULTS After adjustment, lower thicknesses of most inner retinal layers were significantly associated with worse cognitive performance, lower grey and white matter volume, lower hippocampal volume, and worse brain white matter network structure assessed from lower whole brain node degree, lower global efficiency, higher clustering coefficient, and higher local efficiency. DISCUSSION The retina may provide biomarkers that are informative of cerebral neurodegenerative changes in the pathobiology of dementia.
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Grants
- 31O.041 OP-Zuid, the Province of Limburg, the Dutch Ministry of Economic Affairs
- Stichting De Weijerhorst (Maastricht, the Netherlands), the Pearl String Initiative Diabetes (Amsterdam, the Netherlands), the Cardiovascular Center (CVC, Maastricht, the Netherlands), CARIM School for Cardiovascular Diseases (Maastricht, the Netherlands), CAPHRI School for Public Health and Primary Care (Maastricht, the Netherlands), NUTRIM School for Nutrition and Translational Research in Metabolism (Maastricht, the Netherlands), Stichting Annadal (Maastricht, the Netherlands), Health Foundation Limburg (Maastricht, the Netherlands), Perimed (Järfälla, Sweden), and by unrestricted grants from Janssen-Cilag B.V. (Tilburg, the Netherlands), Novo Nordisk Farma B.V. (Alphen aan den Rijn, the Netherlands), and Sanofi-Aventis Netherlands B.V. (Gouda, the Netherlands)
- 916.19.074 VENI research
- 2018T025 Netherlands Organization for Scientific Research and the Netherlands Organization for Health Research and Development, and a Dutch Heart Foundation research
- 2021.81.004 Diabetes Fonds Fellowship
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Schmitt A, Beran M, Geraets A, Iversen MM, Nefs G, Nouwen A, Pouwer F, Huber JW, Schram MT. Associations between HbA1c Reduction and Change in Depressive Symptoms following Glucose-lowering Treatment in Adults: A Systematic Review of Intervention Studies. Curr Diabetes Rev 2024; 20:e020623217607. [PMID: 37278034 DOI: 10.2174/1573399820666230602124223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 04/18/2023] [Accepted: 05/03/2023] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Hyperglycemia constitutes a likely pathway linking diabetes and depressive symptoms; lowering glycemic levels may help reduce diabetes-comorbid depressive symptoms. Since randomized controlled trials can help understand temporal associations, we systematically reviewed the evidence regarding the potential association of hemoglobin HbA1c lowering interventions with depressive symptoms. METHODS PubMed, PsycINFO, CINAHL, and EMBASE databases were searched for randomized controlled trials evaluating HbA1c-lowering interventions and including assessment of depressive symptoms published between 01/2000-09/2020. Study quality was evaluated using the Cochrane Risk of Bias tool. PROSPERO registration: CRD42020215541. RESULTS We retrieved 1,642 studies of which twelve met our inclusion criteria. Nine studies had high and three unclear risks of bias. Baseline depressive symptom scores suggest elevated depressive symptoms in five studies. Baseline HbA1c was <8.0% (<64 mmol/mol) in two, 8.0-9.0% (64-75 mmol/mol) in eight, and ≥10.0% (≥86 mmol/mol) in two studies. Five studies found greater HbA1c reduction in the treatment group; three of these found greater depressive symptom reduction in the treatment group. Of four studies analyzing whether the change in HbA1c was associated with the change in depressive symptoms, none found a significant association. The main limitation of these studies was relatively low levels of depressive symptoms at baseline, limiting the ability to show a lowering in depressive symptoms after HbA1c reduction. CONCLUSIONS We found insufficient available data to estimate the association between HbA1c reduction and depressive symptom change following glucose-lowering treatment. Our findings point to an important gap in the diabetes treatment literature. Future clinical trials testing interventions to improve glycemic outcomes might consider measuring depressive symptoms as an outcome to enable analyses of this association.
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Affiliation(s)
- Andreas Schmitt
- Research Institute Diabetes Academy Mergentheim (FIDAM), Diabetes Center Mergentheim (DZM), Johann-Hammer- Straße 24, 97980 Bad Mergentheim, Germany
- German Center for Diabetes Research (DZD), Ingolstädter Landstraße 1, 85764, Oberschleißheim, Germany
| | - Magdalena Beran
- Department of Internal Medicine, School for Cardiovascular Diseases (CARIM), Maastricht University, Universiteitssingel 50, 6229 ER Maastricht, The Netherlands
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Universiteitsweg 100, 3584 CG Utrecht, The Netherlands
| | - Anouk Geraets
- Department of Internal Medicine, School for Cardiovascular Diseases (CARIM), Maastricht University, Universiteitssingel 50, 6229 ER Maastricht, The Netherlands
- Department of Psychiatry and Neuropsychology, MHeNs School for Mental Health and Neuroscience, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands
| | - Marjolein M Iversen
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Inndalsveien 28, 5063 Bergen, Norway
| | - Giesje Nefs
- Department of Medical and Clinical Psychology, Center of Research on Psychological and Somatic Disorders (CoRPS), Tilburg University, Warandelaan 2, 5037 AB Tilburg, The Netherlands
- Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Geert Grooteplein 27, 6525 EZ Nijmegen, The Netherlands
- Diabeter, National Treatment and Research Center for Children, Adolescents and Young Adults with Type 1 Diabetes, Blaak 6, 3011 TA Rotterdam, The Netherlands
| | - Arie Nouwen
- Department of Psychology, Middlesex University London, The Burroughs, London NW4 4BT, United Kingdom
- School of Health, Wellbeing and Social Care, The Open University, Walton Hall, Milton Keynes MK7 6AA, United Kingdom
| | - Frans Pouwer
- Department of Psychology, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
- Steno Diabetes Center Odense (SDCO), Odense University Hospital, J. B. Winsløws Vej 4, 5000 Odense C, Denmark
| | - Jörg W Huber
- School of Sport and Health Sciences, University of Brighton, Westlain House, Brighton BN1 9PH, United Kingdom
| | - Miranda T Schram
- Department of Internal Medicine, School for Cardiovascular Diseases (CARIM), Maastricht University, Universiteitssingel 50, 6229 ER Maastricht, The Netherlands
- Department of Psychiatry and Neuropsychology, MHeNs School for Mental Health and Neuroscience, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands
- Heart and Vascular Centre, Maastricht University Medical Center, Professor Debyelaan 25, 6229HX Maastricht, The Netherlands
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9
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Truin LS, Köhler S, Heger IS, van Boxtel MPJ, Schram MT, Backes WH, Jansen JFA, van Dongen MMCJM, de Vries NK, de Vries H, Eussen SJPM, Stehouwer CDA, de Vugt ME, Deckers K. Associations of an individual's need for cognition with structural brain damage and cognitive functioning/impairment: cross-sectional population-based study. Br J Psychiatry 2023:1-9. [PMID: 38105553 DOI: 10.1192/bjp.2023.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
BACKGROUND High cognitive activity possibly reduces the risk of cognitive decline and dementia. AIMS To investigate associations between an individual's need to engage in cognitively stimulating activities (need for cognition, NFC) and structural brain damage and cognitive functioning in the Dutch general population with and without existing cognitive impairment. METHOD Cross-sectional data were used from the population-based cohort of the Maastricht Study. NFC was measured using the Need For Cognition Scale. Cognitive functioning was tested in three domains: verbal memory, information processing speed, and executive functioning and attention. Values 1.5 s.d. below the mean were defined as cognitive impairment. Standardised volumes of white matter hyperintensities (WMH), cerebrospinal fluid (CSF) and presence of cerebral small vessel disease (CSVD) were derived from 3T magnetic resonance imaging. Multiple linear and binary logistic regression analyses were used adjusted for demographic, somatic and lifestyle factors. RESULTS Participants (n = 4209; mean age 59.06 years, s.d. = 8.58; 50.1% women) with higher NFC scores had higher overall cognition scores (B = 0.21, 95% CI 0.17-0.26, P < 0.001) and lower odds for CSVD (OR = 0.74, 95% CI 0.60-0.91, P = 0.005) and cognitive impairment (OR = 0.60, 95% CI 0.48-0.76, P < 0.001) after adjustment for demographic, somatic and lifestyle factors. The association between NFC score and cognitive functioning was similar for individuals with and without prevalent cognitive impairment. We found no significant association between NFC and WMH or CSF volumes. CONCLUSIONS A high need to engage in cognitively stimulating activities is associated with better cognitive functioning and less presence of CSVD and cognitive impairment. This suggests that, in middle-aged individuals, motivation to engage in cognitively stimulating activities may be an opportunity to improve brain health.
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Affiliation(s)
- Lotte S Truin
- School for Mental Health & Neuroscience (MHeNs), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands; and Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Sebastian Köhler
- School for Mental Health & Neuroscience (MHeNs), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands; and Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Irene S Heger
- School for Mental Health & Neuroscience (MHeNs), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands; and Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Martin P J van Boxtel
- School for Mental Health & Neuroscience (MHeNs), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands; and Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Miranda T Schram
- School for Mental Health & Neuroscience (MHeNs), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands; School for Cardiovascular Diseases (CARIM), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands; Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands; and Maastricht Heart and Vascular Center, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Walter H Backes
- School for Mental Health & Neuroscience (MHeNs), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands; School for Cardiovascular Diseases (CARIM), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands; and Department of Radiology & Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jacobus F A Jansen
- School for Mental Health & Neuroscience (MHeNs), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Martien M C J M van Dongen
- Department of Epidemiology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Nanne K de Vries
- Department of Health Promotion, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Hein de Vries
- Department of Health Promotion, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Simone J P M Eussen
- School for Cardiovascular Diseases (CARIM), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands; Department of Epidemiology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands; and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Coen D A Stehouwer
- School for Cardiovascular Diseases (CARIM), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Marjolein E de Vugt
- School for Mental Health & Neuroscience (MHeNs), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands; and Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Kay Deckers
- School for Mental Health & Neuroscience (MHeNs), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands; and Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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10
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Mokhtar SBA, van der Heide FCT, Oyaert KAM, van der Kallen CJH, Berendschot TTJM, Scarpa F, Colonna A, de Galan BE, van Greevenbroek MMJ, Dagnelie PC, Schalkwijk CG, Nuijts RMMA, Schaper NC, Kroon AA, Schram MT, Webers CAB, Stehouwer CDA. (Pre)diabetes and a higher level of glycaemic measures are continuously associated with corneal neurodegeneration assessed by corneal confocal microscopy: the Maastricht Study. Diabetologia 2023; 66:2030-2041. [PMID: 37589735 PMCID: PMC10541833 DOI: 10.1007/s00125-023-05986-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 06/13/2023] [Indexed: 08/18/2023]
Abstract
AIMS/HYPOTHESIS To assess the associations between glucose metabolism status and a range of continuous measures of glycaemia with corneal nerve fibre measures, as assessed using corneal confocal microscopy. METHODS We used population-based observational cross-sectional data from the Maastricht Study of N=3471 participants (mean age 59.4 years, 48.4% men, 14.7% with prediabetes, 21.0% with type 2 diabetes) to study the associations, after adjustment for demographic, cardiovascular risk and lifestyle factors, between glucose metabolism status (prediabetes and type 2 diabetes vs normal glucose metabolism) plus measures of glycaemia (fasting plasma glucose, 2 h post-load glucose, HbA1c, skin autofluorescence [SAF] and duration of diabetes) and composite Z-scores of corneal nerve fibre measures or individual corneal nerve fibre measures (corneal nerve bifurcation density, corneal nerve density, corneal nerve length and fractal dimension). We used linear regression analysis, and, for glucose metabolism status, performed a linear trend analysis. RESULTS After full adjustment, a more adverse glucose metabolism status was associated with a lower composite Z-score for corneal nerve fibre measures (β coefficients [95% CI], prediabetes vs normal glucose metabolism -0.08 [-0.17, 0.03], type 2 diabetes vs normal glucose metabolism -0.14 [-0.25, -0.04]; linear trend analysis showed a p value of 0.001), and higher levels of measures of glycaemia (fasting plasma glucose, 2 h post-load glucose, HbA1c, SAF and duration of diabetes) were all significantly associated with a lower composite Z-score for corneal nerve fibre measures (per SD: -0.09 [-0.13, -0.05], -0.07 [-0.11, -0.03], -0.08 [-0.11, -0.04], -0.05 [-0.08, -0.01], -0.09 [-0.17, -0.001], respectively). In general, directionally similar associations were observed for individual corneal nerve fibre measures. CONCLUSIONS/INTERPRETATION To our knowledge, this is the first population-based study to show that a more adverse glucose metabolism status and higher levels of glycaemic measures were all linearly associated with corneal neurodegeneration after adjustment for an extensive set of potential confounders. Our results indicate that glycaemia-associated corneal neurodegeneration is a continuous process that starts before the onset of type 2 diabetes. Further research is needed to investigate whether early reduction of hyperglycaemia can prevent corneal neurodegeneration.
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Grants
- the Cardiovascular Center (CVC, Maastricht, the Netherlands)
- Sanofi-Aventis Netherlands B.V. (Gouda, the Netherlands)
- Perimed (Järfälla, Sweden)
- Janssen-Cilag B.V. (Tilburg, the Netherlands)
- CARIM School for Cardiovascular Diseases (Maastricht, the Netherlands)
- MHeNS School of Mental Health and Neuroscience (Maastricht, the Netherlands)
- CAPHRI School for Public Health and Primary Care (Maastricht, the Netherlands)
- Stichting De Weijerhorst (Maastricht, the Netherlands)
- Health Foundation Limburg (Maastricht, the Netherlands)
- uropean Regional Development Fund via OP-Zuid, the Province of Limburg, the Dutch Ministry of Economic Affairs
- Stichting Annadal (Maastricht, the Netherlands)
- Novo Nordisk Farma B.V. (Alphen aan den Rijn, the Netherlands)
- NUTRIM School for Nutrition and Translational Research in Metabolism (Maastricht, the Netherlands)
- the Pearl String Initiative Diabetes (Amsterdam, the Netherlands)
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Affiliation(s)
- Sara B A Mokhtar
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands.
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands.
- School of Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands.
- University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands.
| | - Frank C T van der Heide
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
- School of Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
- University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Karel A M Oyaert
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
- School of Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Carla J H van der Kallen
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Tos T J M Berendschot
- School of Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
- University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Fabio Scarpa
- Department of Information Engineering, University of Padova, Padova, Italy
| | - Alessia Colonna
- Department of Information Engineering, University of Padova, Padova, Italy
| | - Bastiaan E de Galan
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Marleen M J van Greevenbroek
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Pieter C Dagnelie
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Casper G Schalkwijk
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Rudy M M A Nuijts
- University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Nicolaas C Schaper
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Internal Medicine, Division of Endocrinology and Metabolic Disease, Maastricht University Medical Center, Maastricht, the Netherlands
- Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Abraham A Kroon
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
- Heart and Vascular Center, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Miranda T Schram
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
- Heart and Vascular Center, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Carroll A B Webers
- University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Coen D A Stehouwer
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
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11
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Chan JA, Bosma H, Drosinou C, Timmermans EJ, Savelberg H, Schaper N, Schram MT, Stehouwer CDA, Lakerveld J, Koster A. Association of perceived and objective neighborhood walkability with accelerometer-measured physical activity and sedentary time in the Maastricht Study. Scand J Med Sci Sports 2023; 33:2313-2322. [PMID: 37489093 DOI: 10.1111/sms.14455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 07/11/2023] [Accepted: 07/12/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND We investigated the association of neighborhood walkability with accelerometer-measured physical activity (PA) and sedentary behavior (SB) and examined whether objective and subjective measures of walkability resulted in similar findings. METHODS PA and SB from the first 7689 Maastricht Study participants ages 40-75 from 2010 to 2017 were measured using accelerometers for 7 days. Mean daily step count, light-intensity PA, moderate- to vigorous- intensity PA (MVPA), and SB were calculated. Objective walkability was measured by the 7-component Dutch Walkability Index within 500 m Euclidean buffers around residential addresses of participants. Subjective walkability was obtained from the Abbreviated Neighborhood Environment Walkability Scale. Linear regression models analyzed the associations of walkability with PA and SB, controlling for potential confounders. RESULTS Objective walkability was negatively associated with light intensity PA in the most walkable quartile (b = -14.58, 95% CI = -20.94, -8.23). Compared to participants living in the least walkable neighborhoods, those in the most walkable quartile had statistically significantly higher SB levels (b = 11.64, 95% CI = 4.95, 18.32). For subjective walkability, mean daily step count was significantly higher in the most walkable quartile (b = 509.60, 95% CI = 243.38, 775.81). Higher subjective walkability was positively associated with MVPA (b = 4.40, 95% CI = 2.56, 6.23). CONCLUSION Living in a neighborhood with higher objective walkability was associated with lower levels of PA and higher SB levels while higher subjective walkability was associated with higher levels of PA. These results show discordant findings and thus, the effect of walkability on participant PA and SB within our sample is to be determined.
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Grants
- Cardiovascular Center (CVC, Maastricht, the Netherlands)
- Cardiovascular Research Institute Maastricht (CARIM, Maastricht, the Netherlands)
- Dutch Ministry of Economic Affairs (grant 31O.041)
- European Regional Development Fund
- Health Foundation Limburg (Maastricht, the Netherlands)
- Janssen-Cilag B.V. (Tilburg, the Netherlands)
- Novo Nordisk Farma B.V. (Alphen aan den Rijn, the Netherlands)
- Pearl String Initiative Diabetes (Amsterdam, the Netherlands)
- Province of Limburg
- Sanofi-Aventis Netherlands, B.V. (Gouda, the Netherlands)
- School for Nutrition, Toxicology and Metabolism (NUTRIM, Maastricht, the Netherlands)
- School for Public Health and Primary Care (CAPHRI, Maastricht, the Netherlands)
- Stichting Annadal (Maastricht, the Netherlands)
- Stichting De Weijerhorst (Maastricht, the Netherlands)
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Affiliation(s)
- Jeffrey Alexander Chan
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Department of Social Medicine, Maastricht University, Maastricht, The Netherlands
- Department of Physical Medicine and Rehabilitation, Northern California VA Healthcare System, Martinez, California, USA
| | - Hans Bosma
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Department of Social Medicine, Maastricht University, Maastricht, The Netherlands
| | - Connie Drosinou
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Department of Social Medicine, Maastricht University, Maastricht, The Netherlands
| | - Erik J Timmermans
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Hans Savelberg
- School for Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
| | - Nicolaas Schaper
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- Department of Internal Medicine, Maastricht University, Maastricht, The Netherlands
| | - Miranda T Schram
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- Department of Internal Medicine, Maastricht University, Maastricht, The Netherlands
- Heart and Vascular Centre, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Coen D A Stehouwer
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- Department of Internal Medicine, Maastricht University, Maastricht, The Netherlands
| | - Jeroen Lakerveld
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Annemarie Koster
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Department of Social Medicine, Maastricht University, Maastricht, The Netherlands
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Geerling R, Anglim J, Kothe EJ, Schram MT, Holmes-Truscott E, Speight J. Relationships between personality, emotional well-being, self-efficacy and weight management among adults with type 2 diabetes: Results from a cross-sectional survey. PLoS One 2023; 18:e0292553. [PMID: 37903137 PMCID: PMC10615271 DOI: 10.1371/journal.pone.0292553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 09/24/2023] [Indexed: 11/01/2023] Open
Abstract
The objective of this study was to examine the associations between personality, general and diabetes-specific well-being and self-efficacy, and weight management indicators, among adults with type 2 diabetes. In addition, to examine whether personality provides incremental explanation of variance in weight management indicators. Australian adults with type 2 diabetes (N = 270; 56% women; age: 61±12 years) were recruited via the national diabetes registry. An online survey included measures of: personality (HEXACO-PI-R), weight management indicators (physical activity, healthy diet, body mass index [BMI]), general well-being (WHO-5), general self-efficacy (GSE), diabetes distress (DDS) and diabetes self-efficacy (DMSES). Analyses included bivariate correlations and linear regression, adjusted for demographic, clinical, and psychological variables. All six personality domains showed significant correlation with at least one weight management indicator: physical activity with extraversion (r = .28), conscientiousness (r = .18) and openness (r = .19); healthy diet with honesty-humility (r = .19), extraversion (r = .24), and agreeableness (r = .14); and BMI with emotionality (r = .20) and extraversion (r = -.20). The strongest associations with general and diabetes-specific well-being and self-efficacy were apparent for extraversion, emotionality and conscientiousness (range: r = -.47-.66). Beyond covariates, personality domains explained additional variance for physical activity (Adjusted R2 = .31, R2 difference = .03, p = .03; openness: β = .16, p = .02, emotionality: β = .15, p = .04) and healthy diet (Adjusted R2 = .19, R2 difference = .03, p = .02; honesty-humility: β = .20, p = .002, extraversion: β = .19, p = .04) but not BMI. This study shows that personality is associated with weight management indicators and psychological factors among adults with type 2 diabetes. Further research is needed, including objective measurement of weight management indictors, to examine how personality influences the experience of type 2 diabetes.
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Affiliation(s)
- Ralph Geerling
- School of Psychology, Deakin University, Geelong, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Australia
| | - Jeromy Anglim
- School of Psychology, Deakin University, Geelong, Australia
| | - Emily J. Kothe
- School of Psychology, Deakin University, Geelong, Australia
| | - Miranda T. Schram
- Department of Internal Medicine, School of Cardiovascular Disease (CARIM), Maastricht University, Maastricht, The Netherlands
- Heart and Vascular Center, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Elizabeth Holmes-Truscott
- School of Psychology, Deakin University, Geelong, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Australia
| | - Jane Speight
- School of Psychology, Deakin University, Geelong, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Australia
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13
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Albers JD, Meertens RM, Savelberg HHCM, Köhler S, Wesselius A, Schram MT, Stehouwer CDA, de Galan BE, van Greevenbroek MMJ, van der Kallen CJH, Eussen SJPM, Bosma H, Schaper NC, Koster A. Both short and long sleep durations are associated with type 2 diabetes, independent from traditional lifestyle risk factors-The Maastricht Study. Sleep Health 2023; 9:733-741. [PMID: 37573207 DOI: 10.1016/j.sleh.2023.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 05/17/2023] [Accepted: 06/27/2023] [Indexed: 08/14/2023]
Abstract
OBJECTIVES This study examined the cross-sectional association between sleep duration, prediabetes, and type 2 diabetes, and its independence from the traditional lifestyle risk factors diet, physical activity, smoking behavior, and alcohol consumption. METHODS Cross-sectional data from 5561 people aged 40-75 years recruited into The Maastricht Study between 2010 and 2018 were used (1:1 female:male and mean age: 60.1 years [standard deviation: 8.6]). Sleep duration was operationalized as in-bed time, algorithmically derived from activPAL3 accelerometer data (median 7 nights, IQR 1). Glucose metabolism status was determined with an oral glucose tolerance test. Multinomial logistic regression was used to assess the association of sleep duration as restricted cubic spline with prediabetes and type 2 diabetes. We adjusted for sex, age, educational level, the use of sleep medication or antidepressants, and the following lifestyle risk factors: diet quality, physical activity, smoking behavior, and alcohol consumption. RESULTS A U-shaped association between sleep duration and type 2 diabetes was found. Compared to those with a sleep duration of 8 hours, participants with a sleep duration of 5 and 12 hours had higher odds of type 2 diabetes (OR: 2.9 [95% CI 1.9 to 4.4] and OR 3.2 [2.0 to 5.2], respectively). This association remained after further adjustment for the lifestyle risk factors (OR: 2.6 [1.7 to 4.1] and OR 1.8 [1.1 to 3.1]). No such association was observed between sleep duration and prediabetes. CONCLUSIONS Both short and long sleep durations are associated positively and independently of lifestyle and cardiovascular risk factors with type 2 diabetes, but not with prediabetes.
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Affiliation(s)
- Jeroen D Albers
- Department of Social Medicine, Maastricht University, Maastricht, the Netherlands; Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands.
| | - Ree M Meertens
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands; School for Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, the Netherlands; Department of Health Promotion, Maastricht University, Maastricht, the Netherlands
| | - Hans H C M Savelberg
- School for Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, the Netherlands; Department of Human Movement Sciences, Maastricht University, Maastricht, the Netherlands
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, the Netherlands; School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, the Netherlands
| | - Anke Wesselius
- School for Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, the Netherlands; Department of Genetics & Cell Biology, Complex Genetics, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Miranda T Schram
- School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, the Netherlands; Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands; Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Coen D A Stehouwer
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands
| | - Bastiaan E de Galan
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands; Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Marleen M J van Greevenbroek
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands
| | - Carla J H van der Kallen
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands
| | - Simone J P M Eussen
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands; Department of Epidemiology, Maastricht University, Maastricht, the Netherlands
| | - Hans Bosma
- Department of Social Medicine, Maastricht University, Maastricht, the Netherlands; Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Nicolaas C Schaper
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands; Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands
| | - Annemarie Koster
- Department of Social Medicine, Maastricht University, Maastricht, the Netherlands; Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
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14
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Geraets AFJ, Köhler S, Vergoossen LWM, Backes WH, Stehouwer CD, Verhey FRJ, Jansen JFA, van Sloten TT, Schram MT. The association of white matter connectivity with prevalence, incidence and course of depressive symptoms: The Maastricht Study. Psychol Med 2023; 53:5558-5568. [PMID: 36069192 PMCID: PMC10493191 DOI: 10.1017/s0033291722002768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 06/27/2022] [Accepted: 08/08/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Altered white matter brain connectivity has been linked to depression. The aim of this study was to investigate the association of markers of white matter connectivity with prevalence, incidence and course of depressive symptoms. METHODS Markers of white matter connectivity (node degree, clustering coefficient, local efficiency, characteristic path length, and global efficiency) were assessed at baseline by 3 T MRI in the population-based Maastricht Study (n = 4866; mean ± standard deviation age 59.6 ± 8.5 years, 49.0% women; 17 406 person-years of follow-up). Depressive symptoms (9-item Patient Health Questionnaire; PHQ-9) were assessed at baseline and annually over seven years of follow-up. Major depressive disorder (MDD) was assessed with the Mini-International Neuropsychiatric Interview at baseline only. We used negative binominal, logistic and Cox regression analyses, and adjusted for demographic, cardiovascular, and lifestyle risk factors. RESULTS A lower global average node degree at baseline was associated with the prevalence and persistence of clinically relevant depressive symptoms [PHQ-9 ⩾ 10; OR (95% confidence interval) per standard deviation = 1.21 (1.05-1.39) and OR = 1.21 (1.02-1.44), respectively], after full adjustment. On the contrary, no associations were found of global average node degree with the MDD at baseline [OR 1.12 (0.94-1.32) nor incidence or remission of clinically relevant depressive symptoms [HR = 1.05 (0.95-1.17) and OR 1.08 (0.83-1.41), respectively]. Other connectivity measures of white matter organization were not associated with depression. CONCLUSIONS Our findings suggest that fewer white matter connections may contribute to prevalent depressive symptoms and its persistence but not to incident depression. Future studies are needed to replicate our findings.
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Affiliation(s)
- Anouk F. J. Geraets
- Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, the Netherlands
- Alzheimer Centrum Limburg, Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
- Heart and Vascular Center, Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, the Netherlands
- Alzheimer Centrum Limburg, Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
| | - Laura WM Vergoossen
- Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, the Netherlands
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
- School for Mental Health and Neuroscience, Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Walter H. Backes
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
- School for Mental Health and Neuroscience, Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Coen D.A. Stehouwer
- Department of Internal Medicine, Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
- Heart and Vascular Center, Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
| | - Frans RJ Verhey
- Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, the Netherlands
- Alzheimer Centrum Limburg, Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
| | - Jacobus FA Jansen
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
- School for Mental Health and Neuroscience, Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Thomas T. van Sloten
- Department of Internal Medicine, Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
- Heart and Vascular Center, Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
| | - Miranda T. Schram
- Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
- Heart and Vascular Center, Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
- School for Cardiovascular Diseases (CARIM), Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, the Netherlands
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15
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Erdős B, van Sloun B, Goossens GH, O'Donovan SD, de Galan BE, van Greevenbroek MMJ, Stehouwer CDA, Schram MT, Blaak EE, Adriaens ME, van Riel NAW, Arts ICW. Quantifying postprandial glucose responses using a hybrid modeling approach: Combining mechanistic and data-driven models in The Maastricht Study. PLoS One 2023; 18:e0285820. [PMID: 37498860 PMCID: PMC10374070 DOI: 10.1371/journal.pone.0285820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 05/03/2023] [Indexed: 07/29/2023] Open
Abstract
Computational models of human glucose homeostasis can provide insight into the physiological processes underlying the observed inter-individual variability in glucose regulation. Modelling approaches ranging from "bottom-up" mechanistic models to "top-down" data-driven techniques have been applied to untangle the complex interactions underlying progressive disturbances in glucose homeostasis. While both approaches offer distinct benefits, a combined approach taking the best of both worlds has yet to be explored. Here, we propose a sequential combination of a mechanistic and a data-driven modeling approach to quantify individuals' glucose and insulin responses to an oral glucose tolerance test, using cross sectional data from 2968 individuals from a large observational prospective population-based cohort, the Maastricht Study. The best predictive performance, measured by R2 and mean squared error of prediction, was achieved with personalized mechanistic models alone. The addition of a data-driven model did not improve predictive performance. The personalized mechanistic models consistently outperformed the data-driven and the combined model approaches, demonstrating the strength and suitability of bottom-up mechanistic models in describing the dynamic glucose and insulin response to oral glucose tolerance tests.
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Affiliation(s)
- Balázs Erdős
- TiFN, Wageningen, Netherlands
- MaCSBio Maastricht Centre for Systems Biology, Maastricht University, Maastricht, Netherlands
| | - Bart van Sloun
- TiFN, Wageningen, Netherlands
- MaCSBio Maastricht Centre for Systems Biology, Maastricht University, Maastricht, Netherlands
| | - Gijs H Goossens
- TiFN, Wageningen, Netherlands
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
| | - Shauna D O'Donovan
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Bastiaan E de Galan
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, Netherlands
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, Netherlands
| | - Marleen M J van Greevenbroek
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, Netherlands
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, Netherlands
| | - Coen D A Stehouwer
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, Netherlands
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, Netherlands
| | - Miranda T Schram
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, Netherlands
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, Netherlands
- MHeNs School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
- Heart and Vascular Center, Maastricht University Medical Center, Maastricht, Netherlands
| | - Ellen E Blaak
- TiFN, Wageningen, Netherlands
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
| | - Michiel E Adriaens
- TiFN, Wageningen, Netherlands
- MaCSBio Maastricht Centre for Systems Biology, Maastricht University, Maastricht, Netherlands
| | - Natal A W van Riel
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Ilja C W Arts
- MaCSBio Maastricht Centre for Systems Biology, Maastricht University, Maastricht, Netherlands
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16
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van Kruining D, Losen M, Crivelli SM, de Jong JJA, Jansen JFA, Backes WH, Monereo‐Sánchez J, van Boxtel MPJ, Köhler S, Linden DEJ, Schram MT, Mielke MM, Martinez‐Martinez P. Plasma ceramides relate to mild cognitive impairment in middle-aged men: The Maastricht Study. Alzheimers Dement (Amst) 2023; 15:e12459. [PMID: 37675435 PMCID: PMC10478166 DOI: 10.1002/dad2.12459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 06/29/2023] [Accepted: 07/01/2023] [Indexed: 09/08/2023]
Abstract
Introduction There is an urgent need for biomarkers identifying individuals at risk of early-stage cognitive impairment. Using cross-sectional data from The Maastricht Study, this study included 197 individuals with mild cognitive impairment (MCI) and 200 cognitively unimpaired individuals aged 40 to 75, matched by age, sex, and educational level. Methods We assessed the association of plasma sphingolipid and ceramide transfer protein (CERT) levels with MCI and adjusted for potentially confounding risk factors. Furthermore, the relationship of plasma sphingolipids and CERTs with magnetic resonance imaging brain volumes was assessed and age- and sex-stratified analyses were performed. Results Associations of plasma ceramide species C18:0 and C24:1 and combined plasma ceramide chain lengths (ceramide risk score) with MCI were moderated by sex, but not by age, and higher levels were associated with MCI in men. No associations were found among women. In addition, higher levels of ceramide C20:0, C22:0, and C24:1, but not the ceramide risk score, were associated with larger volume of the hippocampus after controlling for covariates, independent of MCI. Although higher plasma ceramide C18:0 was related to higher plasma CERT levels, no association of CERT levels was found with MCI or brain volumes. Discussion Our results warrant further analysis of plasma ceramides as potential markers for MCI in middle-aged men. In contrast to previous studies, no associations of plasma sphingolipids with MCI or brain volumes were found in women, independent of age. These results highlight the importance of accounting for sex- and age-related factors when examining sphingolipid and CERT metabolism related to cognitive function.
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Affiliation(s)
- Daan van Kruining
- School for Mental Health and NeuroscienceFaculty of HealthMedicine, and Life SciencesMaastricht UniversityMaastrichtthe Netherlands
- Department of Psychiatry and NeuropsychologyMaastricht UniversityMaastrichtthe Netherlands
| | - Mario Losen
- School for Mental Health and NeuroscienceFaculty of HealthMedicine, and Life SciencesMaastricht UniversityMaastrichtthe Netherlands
- Department of Psychiatry and NeuropsychologyMaastricht UniversityMaastrichtthe Netherlands
| | - Simone M. Crivelli
- Department of PhysiologyUniversity of Kentucky College of MedicineLexingtonKentuckyUSA
| | - Joost J. A. de Jong
- School for Mental Health and NeuroscienceFaculty of HealthMedicine, and Life SciencesMaastricht UniversityMaastrichtthe Netherlands
- Department of Radiology and Nuclear MedicineMaastricht University Medical Center+ (MUMC+)Maastrichtthe Netherlands
| | - Jacobus F. A. Jansen
- School for Mental Health and NeuroscienceFaculty of HealthMedicine, and Life SciencesMaastricht UniversityMaastrichtthe Netherlands
- Department of Radiology and Nuclear MedicineMaastricht University Medical Center+ (MUMC+)Maastrichtthe Netherlands
- Department of Electrical EngineeringEindhoven University of TechnologyEindhoventhe Netherlands
| | - Walter H. Backes
- School for Mental Health and NeuroscienceFaculty of HealthMedicine, and Life SciencesMaastricht UniversityMaastrichtthe Netherlands
- Department of Radiology and Nuclear MedicineMaastricht University Medical Center+ (MUMC+)Maastrichtthe Netherlands
| | - Jennifer Monereo‐Sánchez
- School for Mental Health and NeuroscienceFaculty of HealthMedicine, and Life SciencesMaastricht UniversityMaastrichtthe Netherlands
- Department of Radiology and Nuclear MedicineMaastricht University Medical Center+ (MUMC+)Maastrichtthe Netherlands
| | - Martin P. J. van Boxtel
- School for Mental Health and NeuroscienceFaculty of HealthMedicine, and Life SciencesMaastricht UniversityMaastrichtthe Netherlands
- Department of Psychiatry and NeuropsychologyMaastricht UniversityMaastrichtthe Netherlands
| | - Sebastian Köhler
- School for Mental Health and NeuroscienceFaculty of HealthMedicine, and Life SciencesMaastricht UniversityMaastrichtthe Netherlands
- Department of Psychiatry and NeuropsychologyMaastricht UniversityMaastrichtthe Netherlands
| | - David E. J. Linden
- School for Mental Health and NeuroscienceFaculty of HealthMedicine, and Life SciencesMaastricht UniversityMaastrichtthe Netherlands
- Department of Psychiatry and NeuropsychologyMaastricht UniversityMaastrichtthe Netherlands
| | - Miranda T. Schram
- School for Mental Health and NeuroscienceFaculty of HealthMedicine, and Life SciencesMaastricht UniversityMaastrichtthe Netherlands
- Department of Internal MedicineMaastricht University Medical Center+ (MUMC+)Maastrichtthe Netherlands
- Heart and Vascular CenterMaastricht University Medical Center+ (MUMC+)Maastrichtthe Netherlands
- School for Cardiovascular Diseases (CARIM)Faculty of HealthMedicine, and Life SciencesMaastricht UniversityMaastrichtthe Netherlands
| | - Michelle M. Mielke
- Department of Epidemiology and PreventionWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Pilar Martinez‐Martinez
- School for Mental Health and NeuroscienceFaculty of HealthMedicine, and Life SciencesMaastricht UniversityMaastrichtthe Netherlands
- Department of Psychiatry and NeuropsychologyMaastricht UniversityMaastrichtthe Netherlands
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17
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de Ritter R, Sep SJS, van der Kallen CJH, van Greevenbroek MMJ, Koster A, Eussen SJPM, Dagnelie PC, van Boxtel M, Schram MT, Köhler S, Martens JAJ, Snobl L, Vos RC, Stehouwer CDA, Peters SAE. Sex comparisons in the association of prediabetes and type 2 diabetes with cognitive function, depression, and quality of life: The Maastricht study. Diabet Med 2023; 40:e15115. [PMID: 37052591 DOI: 10.1111/dme.15115] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 03/31/2023] [Accepted: 04/12/2023] [Indexed: 04/14/2023]
Abstract
AIMS There are sex differences in the excess risk of diabetes-associated cardiovascular disease. However, it is not clear whether these sex differences exist with regard to other complications like mental health aspects. Therefore, we investigated sex differences in the association of prediabetes and type 2 diabetes (T2D) with cognitive function, depression, and quality of life (QoL). MATERIALS AND METHODS In a population-based cross-sectional cohort study (n = 7639; age 40-75 years, 50% women, 25% T2D), we estimated sex-specific associations, and differences therein, of prediabetes and T2D (reference: normal glucose metabolism) with measures of cognitive function, depression, and physical and mental QoL. Sex differences were analysed using multiple regression models with interaction terms. RESULTS In general, T2D, but not prediabetes, was associated with higher odds of cognitive impairment, major depressive disorder, and poorer QoL. The odds ratio (OR) of cognitive impairment associated with T2D was 1.29 (95% CI: 0.96-1.72) for women and 1.39 (1.10-1.75) for men. The OR of major depressive disorder associated with T2D was 1.19 (0.69-2.04) for women and 1.68 (1.02-2.75) for men. The mean difference of the physical QoL score (ranging from 0 to 100, with 100 indicating the best possible QoL) associated with T2D was -2.09 (-2.92 to -1.25) for women and -1.81 (-2.48 to -1.13) for men. The mean difference of the mental QoL score associated with T2D was -0.90 (-1.79 to -0.02) for women and -0.52 (-1.23 to 0.20) for men. There was no clear pattern of sex differences in the associations of either prediabetes or T2D with measures of cognitive function, depression, or QoL. CONCLUSIONS In general, T2D was associated with worse cognitive function, depression, and poorer QoL. The strength of these associations was similar among women and men.
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Affiliation(s)
- Rianneke de Ritter
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, the Netherlands
- CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands
| | - Simone J S Sep
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, the Netherlands
- CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands
- Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, the Netherlands
| | - Carla J H van der Kallen
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, the Netherlands
- CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands
| | - Marleen M J van Greevenbroek
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, the Netherlands
- CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands
| | - Annemarie Koster
- Department of Social Medicine, Maastricht University, Maastricht, the Netherlands
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Simone J P M Eussen
- CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- Department of Epidemiology, Maastricht University, Maastricht, the Netherlands
| | - Pieter C Dagnelie
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, the Netherlands
- CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands
| | - Martin van Boxtel
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Miranda T Schram
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, the Netherlands
- CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands
- MHeNs School of Mental Health and Neuroscience, Maastricht University Medical Centre+, Maastricht, the Netherlands
- Heart and Vascular Centre, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre+, Maastricht, the Netherlands
- MHeNs School of Mental Health and Neuroscience, Maastricht University Medical Centre+, Maastricht, the Netherlands
- Alzheimer of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Jordi A J Martens
- Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Lucia Snobl
- Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Rimke C Vos
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands
- Department of Public Health and Primary Care/LUMC-Campus, Leiden University Medical Centre, The Hague, the Netherlands
| | - Coen D A Stehouwer
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, the Netherlands
- CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands
| | - Sanne A E Peters
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands
- The George Institute for Global Health, Imperial College London, London, UK
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18
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Monereo-Sánchez J, Jansen JFA, Köhler S, van Boxtel MPJ, Backes WH, Stehouwer CDA, Kroon AA, Kooman JP, Schalkwijk CG, Linden DEJ, Schram MT. The association of prediabetes and type 2 diabetes with hippocampal subfields volume: The Maastricht study. Neuroimage Clin 2023; 39:103455. [PMID: 37356423 PMCID: PMC10310479 DOI: 10.1016/j.nicl.2023.103455] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/13/2023] [Accepted: 06/18/2023] [Indexed: 06/27/2023]
Abstract
AIMS/HYPOTHESIS We investigated whether prediabetes, type 2 diabetes, and continuous measures of hyperglycemia are associated with tissue volume differences in specific subfields of the hippocampus. METHODS We used cross-sectional data from 4,724 participants (58.7 ± 8.5 years, 51.5% women) of The Maastricht Study, a population-based prospective cohort. Glucose metabolism status was assessed with an oral glucose tolerance test, and defined as type 2 diabetes (n = 869), prediabetes (n = 671), or normal glucose metabolism (n = 3184). We extracted 12 hippocampal subfield volumes per hemisphere with FreeSurfer v6.0 using T1w and FLAIR 3T MRI images. We used multiple linear regression and linear trend analysis, and adjusted for total intracranial volume, demographic, lifestyle, and cardiovascular risk factors. RESULTS Type 2 diabetes was significantly associated with smaller volumes in the hippocampal subfield fimbria (standardized beta coefficient ± standard error (β ± SE) = -0.195 ± 0.04, p-value < 0.001), the hippocampus proper, i.e. Cornu Ammonis (CA) 1, CA2/3, CA4, dentate gyrus, subiculum and presubiculum (β ± SE < -0.105 ± 0.04, p-value < 0.006); as well as the hippocampal tail (β ± SE = -0.162 ± 0.04, p-value < 0.001). Prediabetes showed no significant associations. However, linear trend analysis indicated a dose-response relation from normal glucose metabolism, to prediabetes, to type 2 diabetes. Multiple continuous measures of hyperglycemia were associated with smaller volumes of the subfields fimbria (β ± SE < -0.010 ± 0.011, p-value < 0.001), dentate gyrus (β ± SE < -0.013 ± 0.010, p-value < 0.002), CA3 (β ± SE < -0.014 ± 0.011, p-value < 0.001), and tail (β ± SE < -0.006 ± 0.012, p-value < 0.003). CONCLUSIONS/INTERPRETATION Type 2 diabetes and measures of hyperglycemia are associated with hippocampal subfield atrophy, independently of lifestyle and cardiovascular risk factors. We found evidence for a dose-response relationship from normal glucose metabolism, to prediabetes, to type 2 diabetes. Prediabetes stages could give a window of opportunity for the early prevention of brain disease.
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Affiliation(s)
- Jennifer Monereo-Sánchez
- School for Mental Health & Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands; Department of Radiology & Nuclear Medicine, Maastricht University Medical Center, The Netherlands
| | - Jacobus F A Jansen
- School for Mental Health & Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands; Department of Radiology & Nuclear Medicine, Maastricht University Medical Center, The Netherlands.
| | - Sebastian Köhler
- School for Mental Health & Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands; Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, The Netherlands; Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands.
| | - Martin P J van Boxtel
- School for Mental Health & Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands; Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, The Netherlands; Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands.
| | - Walter H Backes
- School for Mental Health & Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands; Department of Radiology & Nuclear Medicine, Maastricht University Medical Center, The Netherlands; School for Cardiovascular Diseases, Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands.
| | - Coen D A Stehouwer
- School for Cardiovascular Diseases, Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands; Department of Internal Medicine, Maastricht University Medical Center, The Netherlands.
| | - Abraham A Kroon
- School for Cardiovascular Diseases, Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands; Department of Internal Medicine, Maastricht University Medical Center, The Netherlands.
| | - Jeroen P Kooman
- Department of Internal Medicine, Maastricht University Medical Center, The Netherlands; School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands.
| | - Casper G Schalkwijk
- School for Cardiovascular Diseases, Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands; Department of Internal Medicine, Maastricht University Medical Center, The Netherlands.
| | - David E J Linden
- School for Mental Health & Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands.
| | - Miranda T Schram
- School for Mental Health & Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands; School for Cardiovascular Diseases, Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands; Department of Internal Medicine, Maastricht University Medical Center, The Netherlands; Maastricht Heart+Vascular Center, Maastricht University Medical Center, The Netherlands.
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19
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Geraets AFJ, Schram MT, Jansen JFA, Backes WH, Schalkwijk CG, Stehouwer CDA, van Boxtel MPJ, Eussen SJPM, Kooman JP, Verhey FRJ, Köhler S. Corrigendum to "The cardiometabolic depression subtype and its association with clinical characteristics: The Maastricht Study" [J. Affect. Disord. 313 (2022) 110-117]. J Affect Disord 2023; 329:589. [PMID: 36906470 DOI: 10.1016/j.jad.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/13/2023]
Affiliation(s)
- Anouk F J Geraets
- Alzheimer Centrum Limburg, Maastricht University Medical Center (MUMC+), Maastricht, the Netherlands; Department of Psychiatry and Neuropsychology, Maastricht University Medical Center (MUMC+), Maastricht, the Netherlands; Department of Internal Medicine, Maastricht University Medical Center (MUMC+), Maastricht, the Netherlands; School of Mental Health and Neuroscience (MHeNs), Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, the Netherlands; School for Cardiovascular Diseases (CARIM), Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Miranda T Schram
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center (MUMC+), Maastricht, the Netherlands; Department of Internal Medicine, Maastricht University Medical Center (MUMC+), Maastricht, the Netherlands; Heart and Vascular Center, Maastricht University Medical Center (MUMC+), Maastricht, the Netherlands; School of Mental Health and Neuroscience (MHeNs), Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, the Netherlands; School for Cardiovascular Diseases (CARIM), Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Jacobus F A Jansen
- Department of Radiology, Maastricht University Medical Center (MUMC+), Maastricht, the Netherlands; School of Mental Health and Neuroscience (MHeNs), Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Walter H Backes
- Department of Radiology, Maastricht University Medical Center (MUMC+), Maastricht, the Netherlands; School of Mental Health and Neuroscience (MHeNs), Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Casper G Schalkwijk
- Department of Internal Medicine, Maastricht University Medical Center (MUMC+), Maastricht, the Netherlands; School for Cardiovascular Diseases (CARIM), Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Coen D A Stehouwer
- Department of Internal Medicine, Maastricht University Medical Center (MUMC+), Maastricht, the Netherlands; School for Cardiovascular Diseases (CARIM), Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Martin P J van Boxtel
- Alzheimer Centrum Limburg, Maastricht University Medical Center (MUMC+), Maastricht, the Netherlands; Department of Psychiatry and Neuropsychology, Maastricht University Medical Center (MUMC+), Maastricht, the Netherlands; School of Mental Health and Neuroscience (MHeNs), Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Simone J P M Eussen
- Department of Epidemiology, Maastricht University Medical Center (MUMC+), Maastricht, the Netherlands; School for Cardiovascular Diseases (CARIM), Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Jeroen P Kooman
- Department of Internal Medicine, Maastricht University Medical Center (MUMC+), Maastricht, the Netherlands; School for Cardiovascular Diseases (CARIM), Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Frans R J Verhey
- Alzheimer Centrum Limburg, Maastricht University Medical Center (MUMC+), Maastricht, the Netherlands; Department of Psychiatry and Neuropsychology, Maastricht University Medical Center (MUMC+), Maastricht, the Netherlands; School of Mental Health and Neuroscience (MHeNs), Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Sebastian Köhler
- Alzheimer Centrum Limburg, Maastricht University Medical Center (MUMC+), Maastricht, the Netherlands; Department of Psychiatry and Neuropsychology, Maastricht University Medical Center (MUMC+), Maastricht, the Netherlands; School of Mental Health and Neuroscience (MHeNs), Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, the Netherlands.
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20
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van der Heide FCT, Mokhtar S, Khanna A, Said M, Henry RMA, Kroon AA, Dagnelie PC, Eussen SJPM, Berendschot TTJM, Schouten JSAG, Schram MT, van der Kallen CJH, van Greevenbroek MMJ, Wesselius A, Savelberg HHCM, Schaper NC, Webers CAB, Stehouwer CDA. Retinal Functional and Structural Neural Indices: Potential Biomarkers for the Monitoring of Cerebral Neurodegeneration: The Maastricht Study. J Alzheimers Dis 2023:JAD230104. [PMID: 37182886 DOI: 10.3233/jad-230104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
BACKGROUND If retinal indices of neurodegeneration are to be biomarkers for the monitoring of cerebral neurodegeneration, it is important to establish whether potentially modifiable risk factors for dementia are associated with retinal neurodegenerative changes. OBJECTIVE To study associations of dementia risk factors with retinal sensitivity, an index of retinal neural function, and retinal nerve fiber layer (RNFL) thickness, an index of retinal neural structure. METHODS We used cross-sectional data from The Maastricht Study (up to 5,666 participants, 50.5% men, mean age 59.7), and investigated associations with regression analyses (adjusted for potential confounders). RESULTS Most risk factors under study (i.e., hyperglycemia, unhealthy diet, lower cardiorespiratory fitness, smoking, alcohol consumption, and hypertension) were significantly associated with lower retinal sensitivity and lower RNFL thickness. CONCLUSION Findings of this population-based study support the concept that retinal neural indices may be biomarkers for the monitoring of therapeutic strategies that aim to prevent early-stage cerebral neurodegeneration and, ultimately, dementia.
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Affiliation(s)
- Frank C T van der Heide
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), The Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), The Netherlands
- MHeNS School of Mental Health and Neuroscience, Maastricht University (UM), The Netherlands
- University Eye Clinic Maastricht, MUMC+, TheNetherlands
| | - Sara Mokhtar
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), The Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), The Netherlands
- MHeNS School of Mental Health and Neuroscience, Maastricht University (UM), The Netherlands
- University Eye Clinic Maastricht, MUMC+, TheNetherlands
| | - Anjani Khanna
- Department of Ophthalmology, Sharpsight eye hospital, New Delhi, India
| | - Mozhda Said
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), The Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), The Netherlands
| | - Ronald M A Henry
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), The Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), The Netherlands
- Heart and Vascular Centre, MUMC+ Maastricht, The Netherlands
| | - Abraham A Kroon
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), The Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), The Netherlands
| | - Pieter C Dagnelie
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), The Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), The Netherlands
| | - Simone J P M Eussen
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), The Netherlands
- Department of Epidemiology, UM, The Netherlands
- CAPHRI Care and Public Health Research Institute, UM, The Netherlands
| | - Tos T J M Berendschot
- MHeNS School of Mental Health and Neuroscience, Maastricht University (UM), The Netherlands
- University Eye Clinic Maastricht, MUMC+, TheNetherlands
| | - Jan S A G Schouten
- University Eye Clinic Maastricht, MUMC+, TheNetherlands
- Department of Ophthalmology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Miranda T Schram
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), The Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), The Netherlands
- MHeNS School of Mental Health and Neuroscience, Maastricht University (UM), The Netherlands
- Heart and Vascular Centre, MUMC+ Maastricht, The Netherlands
| | - Carla J H van der Kallen
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), The Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), The Netherlands
| | - Marleen M J van Greevenbroek
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), The Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), The Netherlands
| | - Anke Wesselius
- Department of Genetics and Cell Biology, Complex Genetics, UM, The Netherlands
- NUTRIM School for Nutrition and Translational Research in Metabolism, UM, The Netherlands
| | - Hans H C M Savelberg
- NUTRIM School for Nutrition and Translational Research in Metabolism, UM, The Netherlands
- Department of Nutrition and Movement Sciences, UM, The Netherlands
| | - Nicolaas C Schaper
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), The Netherlands
- Department of Social Medicine, MUMC+, The Netherlands
- Department of Internal Medicine, Division of Endocrinology and Metabolic Disease, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Carroll A B Webers
- MHeNS School of Mental Health and Neuroscience, Maastricht University (UM), The Netherlands
- University Eye Clinic Maastricht, MUMC+, TheNetherlands
| | - Coen D A Stehouwer
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), The Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), The Netherlands
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21
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Rinaldi E, van der Heide FC, Bonora E, Trombetta M, Zusi C, Kroon AA, Schram MT, van der Kallen CJ, Wesselius A, Bonadonna R, Mari A, Schalkwijk CG, van Greevenbroek MM, Stehouwer CDA. Lower heart rate variability, an index of worse autonomic function, is associated with worse beta cell response to a glycemic load in vivo-The Maastricht Study. Cardiovasc Diabetol 2023; 22:105. [PMID: 37143089 PMCID: PMC10161476 DOI: 10.1186/s12933-023-01837-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 04/19/2023] [Indexed: 05/06/2023] Open
Abstract
OBJECTIVE We investigated, using population-based data, whether worse autonomic function, estimated from lower 24-hour heart rate variability (HRV), was associated with beta cell function, assessed from beta cell response during an oral glucose tolerance test (OGTT). RESEARCH DESIGN AND METHODS We used cross-sectional data from The Maastricht Study, a population-based cohort study (N = 2,007; age, mean ± SD:60 ± 8 years; 52% men; and 24% with type 2 diabetes). We used linear regression analyses with adjustment for potential confounders (demographic, cardiovascular, and lifestyle factors) to study the associations of time- and frequency-domain HRV (composite scores) with overall beta cell response (estimated from a composite score calculated from: C-peptidogenic index, overall insulin secretion, beta cell glucose sensitivity, beta cell potentiation factor, and beta cell rate sensitivity). In addition, we tested for interaction by sex and glucose metabolism status. RESULTS After full adjustment, lower time- and frequency-domain HRV was significantly associated with lower overall beta cell response composite score (standardized beta, -0.055 [-0.098; -0.011] and - 0.051 [-0.095; -0.007], respectively). These associations were not modified by sex and there was no consistent pattern of interaction by glucose metabolism status. CONCLUSION The present etiological study found that worse autonomic function, estimated from lower HRV, was associated with worse beta cell function, estimated from a composite score in a population-based sample which covered the entire spectrum of glucose metabolism. Hence, autonomic dysfunction may contribute to beta cell dysfunction and, ultimately, to the alteration of glucose metabolism status from normal glucose metabolism to prediabetes and type 2 diabetes.
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Affiliation(s)
- Elisabetta Rinaldi
- Division of Endocrinology, Diabetes and Metabolic Diseases, Department of Medicine, University of Verona, Policlinico GB Rossi, Piazzale L.A. Scuro 10, Verona, 37134, Italy.
| | - Frank Ct van der Heide
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), Maastricht, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), Maastricht, the Netherlands
| | - Enzo Bonora
- Division of Endocrinology, Diabetes and Metabolic Diseases, Department of Medicine, University of Verona, Policlinico GB Rossi, Piazzale L.A. Scuro 10, Verona, 37134, Italy
| | - Maddalena Trombetta
- Division of Endocrinology, Diabetes and Metabolic Diseases, Department of Medicine, University of Verona, Policlinico GB Rossi, Piazzale L.A. Scuro 10, Verona, 37134, Italy
| | - Chiara Zusi
- Division of Endocrinology, Diabetes and Metabolic Diseases, Department of Medicine, University of Verona, Policlinico GB Rossi, Piazzale L.A. Scuro 10, Verona, 37134, Italy
| | - Abraham A Kroon
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), Maastricht, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), Maastricht, the Netherlands
| | - Miranda T Schram
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), Maastricht, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), Maastricht, the Netherlands
- Heart and Vascular Centre, MUMC+, Maastricht, the Netherlands
| | - Carla Jh van der Kallen
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), Maastricht, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), Maastricht, the Netherlands
| | - Anke Wesselius
- Department of Epidemiology, UM, Maastricht, the Netherlands
- NUTRIM School for Nutrition and Translational Research in Metabolism, UM, Maastricht, the Netherlands
| | - Riccardo Bonadonna
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Division of Endocrinology and Metabolic Diseases, Azienda Ospedaliera-Universitaria di Parma, Parma, Italy
| | - Andrea Mari
- Institute of Neuroscience, National Research Council, Padua, Italy
| | - Casper G Schalkwijk
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), Maastricht, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), Maastricht, the Netherlands
| | - Marleen Mj van Greevenbroek
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), Maastricht, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), Maastricht, the Netherlands
| | - Coen DA Stehouwer
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), Maastricht, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), Maastricht, the Netherlands
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22
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de Ritter R, Sep SJS, van Greevenbroek MMJ, Kusters YHAM, Vos RC, Bots ML, Kooi ME, Dagnelie PC, Eussen SJPM, Schram MT, Koster A, Brouwers MCG, van der Sangen NMR, Peters SAE, van der Kallen CJH, Stehouwer CDA. Sex differences in body composition in people with prediabetes and type 2 diabetes as compared with people with normal glucose metabolism: the Maastricht Study. Diabetologia 2023; 66:861-872. [PMID: 36805778 PMCID: PMC10036428 DOI: 10.1007/s00125-023-05880-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 11/22/2022] [Indexed: 02/23/2023]
Abstract
AIMS/HYPOTHESIS Obesity is a major risk factor for type 2 diabetes. However, body composition differs between women and men. In this study we investigate the association between diabetes status and body composition and whether this association is moderated by sex. METHODS In a population-based cohort study (n=7639; age 40-75 years, 50% women, 25% type 2 diabetes), we estimated the sex-specific associations, and differences therein, of prediabetes (i.e. impaired fasting glucose and/or impaired glucose tolerance) and type 2 diabetes (reference: normal glucose metabolism [NGM]) with dual-energy x-ray absorptiometry (DEXA)- and MRI-derived measures of body composition and with hip circumference. Sex differences were analysed using adjusted regression models with interaction terms of sex-by-diabetes status. RESULTS Compared with their NGM counterparts, both women and men with prediabetes and type 2 diabetes had more fat and lean mass and a greater hip circumference. The differences in subcutaneous adipose tissue, hip circumference and total and peripheral lean mass between type 2 diabetes and NGM were greater in women than men (women minus men [W-M] mean difference [95% CI]: 15.0 cm2 [1.5, 28.5], 3.2 cm [2.2, 4.1], 690 g [8, 1372] and 443 g [142, 744], respectively). The difference in visceral adipose tissue between type 2 diabetes and NGM was greater in men than women (W-M mean difference [95% CI]: -14.8 cm2 [-26.4, -3.1]). There was no sex difference in the percentage of liver fat between type 2 diabetes and NGM. The differences in measures of body composition between prediabetes and NGM were generally in the same direction, but were not significantly different between women and men. CONCLUSIONS/INTERPRETATION This study indicates that there are sex differences in body composition associated with type 2 diabetes. The pathophysiological significance of these sex-associated differences requires further study.
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Affiliation(s)
- Rianneke de Ritter
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands.
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands.
| | - Simone J S Sep
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Adelante, Center of Expertise in Rehabilitation and Audiology, Hoensbroek, the Netherlands
| | - Marleen M J van Greevenbroek
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
| | - Yvo H A M Kusters
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
| | - Rimke C Vos
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- Leiden University Medical Center, Department of Public Health and Primary Care/LUMC-Campus, The Hague, the Netherlands
| | - Michiel L Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - M Eline Kooi
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Pieter C Dagnelie
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
| | - Simone J P M Eussen
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Epidemiology, Maastricht University, Maastricht, the Netherlands
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Miranda T Schram
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Heart and Vascular Center, Maastricht University Medical Center+, Maastricht, the Netherlands
- MHeNs School for Mental Health and Neuroscience, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Annemarie Koster
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- Department of Social Medicine, Maastricht University, Maastricht, the Netherlands
| | - Martijn C G Brouwers
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
| | | | - Sanne A E Peters
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- The George Institute for Global Health, Imperial College London, London, UK
| | - Carla J H van der Kallen
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
| | - Coen D A Stehouwer
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
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23
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Wauben B, van der Poel MWM, Greevenbroek MMJ, van Yperen NC, Schram MT, van Boxtel MPJ, Sastry M, Simons SO, Stehouwer CDA, Dagnelie PC, Wesselius A, Schouten HC, Köhler S. Cognitive functioning in survivors of hematopoietic stem cell transplantation compared with a matched general population sample – The MOSA study. Transplant Cell Ther 2023:S2666-6367(23)01200-9. [PMID: 36966872 DOI: 10.1016/j.jtct.2023.03.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/19/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023]
Abstract
Although cognitive problems can recover over time, a subgroup of hematopoietic stem cell transplantation (HCT) survivors experience persistent cognitive problems in the long term. Despite these implications, studies assessing cognitive functioning in HCT survivors are limited. The aim of the present study was (1) to quantify the prevalence of cognitive impairment in patients treated with HCT who survived at least 2 years and to compare these with a matched reference group representing the general population; (2) to identify potential determinants of cognitive functioning within the HCT survivor group. Within the single-center Maastricht Observational study of late effects after Stem cell trAnsplantation, cognitive performance was assessed by a neuropsychological test battery divided into 3 cognitive domains: memory, information processing speed, and executive function and attention. An overall cognition score was calculated as the average of the domain scores. A total of 115 HCT survivors were group-matched on a 1:4 ratio to the reference group by age, sex, and level of education. Regression analyses adjusted for different sets of covariates including demographic and health- and lifestyle-related factors were used to test for differences in cognition between HCT survivors and the reference group resembling the general population. A limited set of clinical characteristics (diagnosis, type of transplant, time since treatment, conditioning regimen with total body irradiation and age at time of transplantation) were assessed as potential determinants of neurocognitive dysfunction among HCT survivors. Cognitive impairment was defined as scores in the cognitive domains < -1.5 standard deviation (SD) from what can be expected based on someone's age, sex, and education. The mean age at time of transplantation was 50.2 (SD ± 11.2) years, and the mean number of years after transplant was 8.7 (SD ± 5.7) years. The majority of HCT survivors were treated with autologous HCT (n = 73 [64%]). The prevalence of cognitive dysfunction was 34.8% in HCT survivors and 21.3% in the reference group (p = .002.) When adjusted for age, sex, and level of education, HCT survivors had a worse overall cognition score (b = -0.35; 95% confidence interval [CI], -0.55 to -0.16; p < .001), translating into 9.0 years of higher cognitive age. Analyses of specific cognitive domain scores showed that HCT survivors scored worse on memory (b = -0.43; 95% CI, -0.73 to -0.13; p = .005), information processing speed (b = -0.33; 95% CI, -0.55 to -0.11; p = .003), and executive function and attention (b = -0.29; 95% CI, -.55 to -.03; p = .031) than the reference group. The odds of cognitive impairment were on average 2.4 times higher among HCT survivors than the reference group (odd ratio = 2.44; 95% CI, 1.47-4.07; p = .001). Within the HCT survivor group none of the tested clinical determinants of cognitive impairment were significantly associated with cognition. This cohort study showed evidence for worse cognitive functioning in HCT survivors encompassing all three cognitive domains, respectively memory, information processing speed, and executive & attention compared to a reference group that represents the general population translating into nine years of faster cognitive ageing in HCT survivors than can be expected based on their chronological age. It is important to increase awareness for signs of neurocognitive dysfunction after HCT in clinicians and HCT survivors.
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Affiliation(s)
- B Wauben
- Department of Internal Medicine, Section Hematology, Maastricht University Medical Center, Maastricht, the Netherlands; School for Oncology and Development Biology (GROW), Maastricht University, Maastricht, the Netherlands.
| | - M W M van der Poel
- Department of Internal Medicine, Section Hematology, Maastricht University Medical Center, Maastricht, the Netherlands; School for Oncology and Development Biology (GROW), Maastricht University, Maastricht, the Netherlands
| | - M M J Greevenbroek
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands; School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, the Netherlands
| | - N C van Yperen
- Department of Internal Medicine, Section Hematology, Maastricht University Medical Center, Maastricht, the Netherlands; School for Oncology and Development Biology (GROW), Maastricht University, Maastricht, the Netherlands
| | - M T Schram
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands; School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, the Netherlands
| | - M P J van Boxtel
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands; School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, The Netherlands
| | - M Sastry
- Academic Sleep Center, CIRO Center of Expertise for Chronic Organ Failure, Horn, The Netherlands
| | - S O Simons
- Department of Respiratory Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
| | - C D A Stehouwer
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands; School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, the Netherlands; School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - P C Dagnelie
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, the Netherlands; School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, the Netherlands; Department of Epidemiology, Maastricht University, Maastricht, the Netherlands
| | - A Wesselius
- Department of Epidemiology, Maastricht University, Maastricht, the Netherlands; School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | - H C Schouten
- Department of Internal Medicine, Section Hematology, Maastricht University Medical Center, Maastricht, the Netherlands; School for Oncology and Development Biology (GROW), Maastricht University, Maastricht, the Netherlands
| | - S Köhler
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands; School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, The Netherlands; Alzheimer Center Limburg, Maastricht University Medical Center, Maastricht, The Netherlands
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Gianfredi V, Dinu M, Nucci D, Eussen SJPM, Amerio A, Schram MT, Schaper N, Odone A. Association between dietary patterns and depression: an umbrella review of meta-analyses of observational studies and intervention trials. Nutr Rev 2023; 81:346-359. [PMID: 36240456 DOI: 10.1093/nutrit/nuac058] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
CONTEXT Depression is the most common causes of disease burden worldwide (GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392:1789-1858). OBJECTIVE An umbrella review has been performed to assess the strength and validity of the available observational and trial evidence for the association between a variety of dietary patterns and depression. DATA SOURCES MEDLINE/PubMed, Scopus, Web of Science, EMBASE, PsycINFO, and Cochrane Database were searched. DATA EXTRACTION The Joanna Briggs Institute Umbrella Review Methodology was used. DATA ANALYSIS The review included 19 articles, covering a relatively wide range of dietary patterns: healthy dietary patterns (n = 8), Mediterranean diet (MedDiet) (n = 6), Dietary Inflammatory Index (DII) (n = 5), Western diet (n = 4), Dietary Approaches to Stop Hypertension (DASH) (n = 2), vegetarian diets (n = 4), and other dietary interventions (n = 2). The methodological quality of the included meta-analyses was generally low or critically low. The strength of the evidence was generally weak, although convincing or suggestive evidence was found for an inverse relationship between MedDiet/DII and depression. Higher adherence to the MedDiet and lower DII score were significantly associated with lower risk of depression. CONCLUSION Considering the generally high heterogeneity and low quality of the available evidence, further studies adopting more coherent and uniform methodologies are needed. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42020223376.
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Affiliation(s)
- Vincenza Gianfredi
- are with the Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.,are with the CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands.,is with the Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Monica Dinu
- is with the Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Daniele Nucci
- is with the Nutritional Support Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Simone J P M Eussen
- are with the Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.,are with the CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands.,is with the Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
| | - Andrea Amerio
- is with the Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy.,is with the IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,is with the Department of Psychiatry, Tufts University, Boston, MA, USA
| | - Miranda T Schram
- are with the CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands.,are with the Department of Internal Medicine, Maastricht University, Maastricht, The Netherlands.,is with the MHeNS School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.,is with the Heart and Vascular Center, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Nicolaas Schaper
- are with the Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.,are with the CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands.,are with the Department of Internal Medicine, Maastricht University, Maastricht, The Netherlands
| | - Anna Odone
- is with the Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
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van Gennip ACE, Schram MT, Köhler S, Kroon AA, Koster A, Eussen SJPM, de Galan BE, van Sloten TT, Stehouwer CDA. Association of type 2 diabetes according to the number of risk factors within the recommended range with incidence of major depression and clinically relevant depressive symptoms: a prospective analysis. Lancet Healthy Longev 2023; 4:e63-e71. [PMID: 36738746 DOI: 10.1016/s2666-7568(22)00291-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Type 2 diabetes is associated with an increased risk of depression, but the extent to which risk factor modification can mitigate this risk is unclear. We aimed to examine the association between the incidence of major depression and clinically relevant depressive symptoms among individuals with type 2 diabetes, according to the number of risk factors within the recommended target range, compared with individuals without diabetes. METHODS We did a prospective analysis of population-based data from the UK Biobank and the Maastricht Study. Individuals with type 2 diabetes were categorised according to the number of risk factors within the recommended target range (non-smoking, guideline-recommended levels of glycated haemoglobin (HbA1c), blood pressure, BMI, albuminuria, physical activity, and diet). The primary outcome, based on data from the UK Biobank, was the incidence of major depression ascertained from hospital records; the secondary outcome, based on data from the UK Biobank and the Maastricht Study, was clinically relevant depressive symptoms based on a score of 10 or higher on the Patient Health Questionnaire (PHQ-9). FINDINGS The study population of the UK Biobank comprised 77 786 individuals (9047 with type 2 diabetes and 68 739 without diabetes; median age 59 years [IQR 51-64]; 34 136 [43·9%] women and 43 650 [56·1%] men). A median of 12·7 years (IQR 11·8-13·4) after recruitment (between March 13, 2006, and Oct 1, 2010), 493 (5·5%) of 9047 individuals with type 2 diabetes and 2574 (3·7%) of 68 739 individuals without diabetes developed major depression. Compared with individuals without diabetes, those with type 2 diabetes had a higher risk of major depression (hazard ratio [HR] 1·61 [95% CI 1·49-1·77]). Among individuals with type 2 diabetes, the excess risk of depression decreased stepwise with an increasing number of risk factors within the recommended target range (HR 2·04 [95% CI 1·65-2·52] for up to two risk factors within the recommended target range; 1·95 [1·65-2·30] for three risk factors within the recommended target range; 1·38 [1·16-1·65] for four risk factors within the recommended target range; and 1·34 [1·12-1·62] for five to seven risk factors within the recommended target range). In the UK Biobank dataset, a median of 7·5 years (IQR 6·8-8·2) after the baseline examination, 147 (7·5%) of 1953 individuals with type 2 diabetes and 954 (4·5%) of 21 413 individuals without diabetes had developed clinically relevant depressive symptoms. The study population of the Maastricht Study comprised 4530 individuals (1158 with type 2 diabetes and 3372 without diabetes; median age 60 years [IQR 53-66]; 2244 [49·5%] women and 2286 [50·1%] men). A median of 5·1 years (IQR 4·1-6·1) after recruitment (between Sept 1, 2010, and Dec 7, 2017), 170 (14·7%) of 1158 individuals with type 2 diabetes and 227 (6·7%) of 3372 individuals without diabetes developed clinically relevant depressive symptoms. Similarly, in both the UK Biobank dataset and the Maastricht Study cohort, among individuals with type 2 diabetes, the excess risk of clinically relevant depressive symptoms decreased stepwise with an increasing number of risk factors within the recommended target range. INTERPRETATION Among individuals with type 2 diabetes, the excess risk of major depression and clinically relevant depressive symptoms decreased stepwise with an increasing number of risk factors within the recommended target range. This study provides further evidence to promote risk factor modification strategies in individuals with type 2 diabetes and to encourage the adoption of a healthy lifestyle. FUNDING ZonMW, Hartstichting, and Diabetes Fonds.
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Affiliation(s)
- April C E van Gennip
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, Netherlands; School for Cardiovascular Diseases CARIM, Maastricht University, Maastricht, Netherlands
| | - Miranda T Schram
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, Netherlands; Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands; School for Cardiovascular Diseases CARIM, Maastricht University, Maastricht, Netherlands; School for Mental Health and Neuroscience MHENS, Maastricht University, Maastricht, Netherlands
| | - Sebastian Köhler
- School for Mental Health and Neuroscience MHENS, Maastricht University, Maastricht, Netherlands; Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, Netherlands
| | - Abraham A Kroon
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, Netherlands; School for Cardiovascular Diseases CARIM, Maastricht University, Maastricht, Netherlands
| | - Annemarie Koster
- Care and Public Health Research Institute CAPHRI, Maastricht University, Maastricht, Netherlands; Department of Social Medicine, Maastricht University, Maastricht, Netherlands
| | - Simone J P M Eussen
- School for Cardiovascular Diseases CARIM, Maastricht University, Maastricht, Netherlands; Care and Public Health Research Institute CAPHRI, Maastricht University, Maastricht, Netherlands; Department of Epidemiology, Maastricht University, Maastricht, Netherlands
| | - Bastiaan E de Galan
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, Netherlands; School for Cardiovascular Diseases CARIM, Maastricht University, Maastricht, Netherlands; Department of Internal Medicine, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Thomas T van Sloten
- Department of Vascular Medicine, University Medical Centre Utrecht, Utrecht, Netherlands.
| | - Coen D A Stehouwer
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, Netherlands; School for Cardiovascular Diseases CARIM, Maastricht University, Maastricht, Netherlands
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26
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Maasen K, Eussen SJPM, Dagnelie PC, Houben AJHM, Webers CAB, Schram MT, Berendschot TTJM, Stehouwer CDA, Opperhuizen A, van Greevenbroek MMJ, Schalkwijk CG. Habitual intake of dietary methylglyoxal is associated with less low-grade inflammation: the Maastricht Study. Am J Clin Nutr 2022; 116:1715-1728. [PMID: 36055771 PMCID: PMC9761753 DOI: 10.1093/ajcn/nqac195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 07/08/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Dicarbonyls are major reactive precursors of advanced glycation endproducts (AGEs). Dicarbonyls are formed endogenously and also during food processing. Circulating dicarbonyls and AGEs are associated with inflammation and microvascular complications of diabetes, but for dicarbonyls from the diet these associations are currently unknown. OBJECTIVES We sought to examine the associations of dietary dicarbonyl intake with low-grade inflammation and microvascular function. METHODS In 2792 participants (mean ± SD age: 60 ± 8 y; 50% men; 26% type 2 diabetes) of the population-based cohort the Maastricht Study, we estimated the habitual intake of the dicarbonyls methylglyoxal (MGO), glyoxal (GO), and 3-deoxyglucosone (3-DG) by linking FFQ outcome data to our food composition database of the MGO, GO, and 3-DG content of >200 foods. Low-grade inflammation was assessed as six plasma biomarkers, which were compiled in a z score. Microvascular function was assessed as four plasma biomarkers, compiled in a zscore; as diameters and flicker light-induced dilation in retinal microvessels; as heat-induced skin hyperemic response; and as urinary albumin excretion. Cross-sectional associations of dietary dicarbonyls with low-grade inflammation and microvascular function were investigated using linear regression with adjustments for age, sex, potential confounders related to cardiometabolic risk factors, and lifestyle and dietary factors. RESULTS Fully adjusted analyses revealed that higher intake of MGO was associated with a lower z score for inflammation [standardized β coefficient (STD β): -0.05; 95% CI: -0.09 to -0.01, with strongest inverse associations for hsCRP and TNF-α: both -0.05; -0.10 to -0.01]. In contrast, higher dietary MGO intake was associated with impaired retinal venular dilation after full adjustment (STD β: -0.07; 95% CI: -0.12 to -0.01), but not with the other features of microvascular function. GO and 3-DG intakes were not consistently associated with any of the outcomes. CONCLUSION Higher habitual intake of MGO was associated with less low-grade inflammation. This novel, presumably beneficial, association is the first observation of an association between MGO intake and health outcomes in humans and warrants further investigation.
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Affiliation(s)
- Kim Maasen
- Department of Internal Medicine, CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Simone J P M Eussen
- Department of Epidemiology, CAPHRI Care and Public Health Research Institute/CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Pieter C Dagnelie
- Department of Epidemiology, CAPHRI Care and Public Health Research Institute/CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Alfons J H M Houben
- Department of Internal Medicine, CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Carroll A B Webers
- University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Miranda T Schram
- Department of Internal Medicine, Heart and Vascular Center, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Tos T J M Berendschot
- University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Coen D A Stehouwer
- Department of Internal Medicine, CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Antoon Opperhuizen
- Department of Pharmacology and Toxicology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
- Office for Risk Assessment and Research, Netherlands Food and Consumer Product Safety Authority, Utrecht, The Netherlands
| | - Marleen M J van Greevenbroek
- Department of Internal Medicine, CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Casper G Schalkwijk
- Department of Internal Medicine, CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, Maastricht, The Netherlands
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27
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Gianfredi V, Schaper NC, Odone A, Signorelli C, Amerio A, Eussen SJPM, Köhler S, Savelberg HHCM, Stehouwer CDA, Dagnelie PC, Henry RMA, van der Kallen CJH, van Greevenbroek MMJ, Schram MT, Koster A. Daily patterns of physical activity, sedentary behavior, and prevalent and incident depression-The Maastricht Study. Scand J Med Sci Sports 2022; 32:1768-1780. [PMID: 36114702 PMCID: PMC9827855 DOI: 10.1111/sms.14235] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/20/2022] [Accepted: 09/08/2022] [Indexed: 01/12/2023]
Abstract
This study aims to compare the accelerometer-measured daily patterns of PA and sedentary behavior among participants with and without prevalent/incident depressive symptoms. We used data from 5582 individuals in The Maastricht Study (59.9 ± 8.6 years, 50.3% women). Daily patterns of sedentary time, light-intensity physical activity (LiPA), moderate-to-vigorous physical activity (MVPA), and sit-to-stand transitions were objectively measured at baseline with the activPAL3 activity monitor. Depressive symptoms were assessed using the 9-item Patient Health Questionnaire, both at baseline and annually (median follow-up: 5.1 years). General linear models were used to compare patterns of physical activity and sedentary behavior between those with and without prevalent/incident depressive symptoms. Participants with prevalent depressive symptoms had significantly more sedentary time (18.6 min/day) and lower LiPA (26.8 min/day) and MVPA (4.8 min/day) than participants without depressive symptoms. Considering the daily patterns, participants with prevalent depressive symptoms had significantly more sedentary time early in the afternoon (12:00-18:00), early evening (18:00-21:00), and during the night (00:00-03:00), less time in LiPA in all periods between 09:00-21.00 and less MVPA in the morning (09:00:12:00), early afternoon (12:00-15:00), and evening (18:00-21:00), than those without. Similar differences in activity and sedentary behavior patterns between those and without incident depressive symptoms were observed albeit the differences were smaller. Overall, we did not find specific time slots particularly associated with both prevalent and incident depressive symptoms. These findings may indicate that less sedentary time and more intense PA can be important targets for the prevention of depression irrespective of the timing of the day.
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Affiliation(s)
- Vincenza Gianfredi
- CAPHRI Care and Public Health Research InstituteMaastricht UniversityMaastrichtThe Netherlands,CARIM School for Cardiovascular DiseasesMaastricht UniversityMaastrichtThe Netherlands,Department of Biomedical Sciences for HealthUniversity of MilanMilanItaly
| | - Nicolaas C. Schaper
- CAPHRI Care and Public Health Research InstituteMaastricht UniversityMaastrichtThe Netherlands,CARIM School for Cardiovascular DiseasesMaastricht UniversityMaastrichtThe Netherlands,Department of Internal MedicineMaastricht UniversityMaastrichtThe Netherlands
| | - Anna Odone
- Department Public Health, Experimental and Forensic MedicineUniversity of PaviaPaviaItaly
| | | | - Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of PsychiatryUniversity of GenoaGenoaItaly,IRCCS Ospedale Policlinico San MartinoGenoaItaly,Mood Disorders ProgramTufts Medical CenterBostonMassachusettsUSA
| | - Simone J. P. M. Eussen
- CAPHRI Care and Public Health Research InstituteMaastricht UniversityMaastrichtThe Netherlands,CARIM School for Cardiovascular DiseasesMaastricht UniversityMaastrichtThe Netherlands,Department of EpidemiologyMaastricht UniversityMaastrichtThe Netherlands
| | - Sebastian Köhler
- MHeNS School for Mental Health and NeuroscienceMaastricht UniversityMaastrichtThe Netherlands,Department of Psychiatry and NeuropsychologyMaastricht UniversityMaastrichtThe Netherlands
| | - Hans H. C. M. Savelberg
- Department of Nutrition and Movement SciencesMaastricht UniversityMaastrichtThe Netherlands,School of Health Professions EducationMaastricht UniversityMaastrichtThe Netherlands,NUTRIM, School for Nutrition and Translation Research MaastrichtMaastricht UniversityMaastrichtThe Netherlands
| | - Coen D. A. Stehouwer
- CARIM School for Cardiovascular DiseasesMaastricht UniversityMaastrichtThe Netherlands,Department of Internal MedicineMaastricht UniversityMaastrichtThe Netherlands
| | - Pieter C. Dagnelie
- CAPHRI Care and Public Health Research InstituteMaastricht UniversityMaastrichtThe Netherlands,CARIM School for Cardiovascular DiseasesMaastricht UniversityMaastrichtThe Netherlands,Department of Internal MedicineMaastricht UniversityMaastrichtThe Netherlands
| | - Ronald M. A. Henry
- CARIM School for Cardiovascular DiseasesMaastricht UniversityMaastrichtThe Netherlands,Department of Internal MedicineMaastricht UniversityMaastrichtThe Netherlands
| | - Carla J. H. van der Kallen
- CARIM School for Cardiovascular DiseasesMaastricht UniversityMaastrichtThe Netherlands,Department of Internal MedicineMaastricht UniversityMaastrichtThe Netherlands
| | - Marleen M. J. van Greevenbroek
- CARIM School for Cardiovascular DiseasesMaastricht UniversityMaastrichtThe Netherlands,Department of Internal MedicineMaastricht UniversityMaastrichtThe Netherlands
| | - Miranda T. Schram
- CARIM School for Cardiovascular DiseasesMaastricht UniversityMaastrichtThe Netherlands,Department of Internal MedicineMaastricht UniversityMaastrichtThe Netherlands,MHeNS School for Mental Health and NeuroscienceMaastricht UniversityMaastrichtThe Netherlands,Heart and Vascular CenterMaastricht University Medical Center+MaastrichtThe Netherlands
| | - Annemarie Koster
- CAPHRI Care and Public Health Research InstituteMaastricht UniversityMaastrichtThe Netherlands,Department of Social MedicineMaastricht UniversityMaastrichtThe Netherlands
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28
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van der Heide FCT, Foreman YD, Franken IWM, Henry RMA, Kroon AA, Dagnelie PC, Eussen SJPM, Berendschot TTJM, Schouten JSAG, Webers CAB, Schram MT, van der Kallen CJH, van Greevenbroek MMJ, Wesselius A, Schalkwijk CG, Schaper NC, Brouwers MCGJ, Stehouwer CDA. (Pre)diabetes, glycemia, and daily glucose variability are associated with retinal nerve fiber layer thickness in The Maastricht Study. Sci Rep 2022; 12:17750. [PMID: 36273238 PMCID: PMC9587985 DOI: 10.1038/s41598-022-22748-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 10/19/2022] [Indexed: 01/13/2023] Open
Abstract
Retinopathy and neuropathy in type 2 diabetes are preceded by retinal nerve fibre layer (RNFL) thinning, an index of neurodegeneration. We investigated whether glucose metabolism status (GMS), measures of glycaemia, and daily glucose variability (GV) are associated with RNFL thickness over the entire range of glucose tolerance. We used cross-sectional data from The Maastricht Study (up to 5455 participants, 48.9% men, mean age 59.5 years and 22.7% with type 2 diabetes) to investigate the associations of GMS, measures of glycaemia (fasting plasma glucose [FPG], 2-h post-load glucose [2-h PG], HbA1c, advanced glycation endproducts [AGEs] assessed as skin autofluorescence [SAF]) and indices of daily GV (incremental glucose peak [IGP] and continuous glucose monitoring [CGM]-assessed standard deviation [SD]) with mean RNFL thickness. We used linear regression analyses and, for GMS, P for trend analyses. We adjusted associations for demographic, cardiovascular risk and lifestyle factors, and, only for measures of GV, for indices of mean glycaemia. After full adjustment, type 2 diabetes and prediabetes (versus normal glucose metabolism) were associated with lower RNFL thickness (standardized beta [95% CI], respectively - 0.16 [- 0.25; - 0.08]; - 0.05 [- 0.13; 0.03]; Ptrend = 0.001). Greater FPG, 2-h PG, HbA1c, SAF, IGP, but not CGM-assessed SD, were also associated with lower RNFL thickness (per SD, respectively - 0.05 [- 0.08; - 0.01]; - 0.06 [- 0.09; - 0.02]; - 0.05 [- 0.08; - 0.02]; - 0.04 [- 0.07; - 0.01]; - 0.06 [- 0.12; - 0.01]; and - 0.07 [- 0.21; 0.07]). In this population-based study, a more adverse GMS and, over the entire range of glucose tolerance, greater glycaemia and daily GV were associated with lower RNFL thickness. Hence, early identification of individuals with hyperglycaemia, early glucose-lowering treatment, and early monitoring of daily GV may contribute to the prevention of RNFL thinning, an index of neurodegeneration and precursor of retinopathy and neuropathy.
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Affiliation(s)
- Frank C. T. van der Heide
- grid.5012.60000 0001 0481 6099CARIM School for Cardiovascular Diseases, Maastricht University (UM), Maastricht, The Netherlands ,grid.412966.e0000 0004 0480 1382Department of Internal Medicine, Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, P.O. Box 5800, 6202AZ Maastricht, The Netherlands
| | - Yuri D. Foreman
- grid.5012.60000 0001 0481 6099CARIM School for Cardiovascular Diseases, Maastricht University (UM), Maastricht, The Netherlands ,grid.412966.e0000 0004 0480 1382Department of Internal Medicine, Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, P.O. Box 5800, 6202AZ Maastricht, The Netherlands
| | - Iris W. M. Franken
- grid.5012.60000 0001 0481 6099CARIM School for Cardiovascular Diseases, Maastricht University (UM), Maastricht, The Netherlands ,grid.412966.e0000 0004 0480 1382Department of Internal Medicine, Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, P.O. Box 5800, 6202AZ Maastricht, The Netherlands
| | - Ronald M. A. Henry
- grid.5012.60000 0001 0481 6099CARIM School for Cardiovascular Diseases, Maastricht University (UM), Maastricht, The Netherlands ,grid.412966.e0000 0004 0480 1382Department of Internal Medicine, Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, P.O. Box 5800, 6202AZ Maastricht, The Netherlands ,grid.412966.e0000 0004 0480 1382Heart and Vascular Center, MUMC+ Maastricht, Maastricht, The Netherlands
| | - Abraham A. Kroon
- grid.5012.60000 0001 0481 6099CARIM School for Cardiovascular Diseases, Maastricht University (UM), Maastricht, The Netherlands ,grid.412966.e0000 0004 0480 1382Department of Internal Medicine, Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, P.O. Box 5800, 6202AZ Maastricht, The Netherlands ,grid.412966.e0000 0004 0480 1382Heart and Vascular Center, MUMC+ Maastricht, Maastricht, The Netherlands
| | - Pieter C. Dagnelie
- grid.5012.60000 0001 0481 6099CARIM School for Cardiovascular Diseases, Maastricht University (UM), Maastricht, The Netherlands ,grid.412966.e0000 0004 0480 1382Department of Internal Medicine, Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, P.O. Box 5800, 6202AZ Maastricht, The Netherlands
| | - Simone J. P. M. Eussen
- grid.5012.60000 0001 0481 6099CARIM School for Cardiovascular Diseases, Maastricht University (UM), Maastricht, The Netherlands ,grid.5012.60000 0001 0481 6099Department of Epidemiology, UM, Maastricht, The Netherlands
| | - Tos T. J. M. Berendschot
- grid.412966.e0000 0004 0480 1382University Eye Clinic Maastricht, MUMC+, Maastricht, The Netherlands
| | - Jan S. A. G. Schouten
- grid.412966.e0000 0004 0480 1382University Eye Clinic Maastricht, MUMC+, Maastricht, The Netherlands ,grid.413327.00000 0004 0444 9008Department of Ophthalmology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Carroll A. B. Webers
- grid.412966.e0000 0004 0480 1382University Eye Clinic Maastricht, MUMC+, Maastricht, The Netherlands
| | - Miranda T. Schram
- grid.5012.60000 0001 0481 6099CARIM School for Cardiovascular Diseases, Maastricht University (UM), Maastricht, The Netherlands ,grid.412966.e0000 0004 0480 1382Department of Internal Medicine, Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, P.O. Box 5800, 6202AZ Maastricht, The Netherlands ,grid.412966.e0000 0004 0480 1382Heart and Vascular Center, MUMC+ Maastricht, Maastricht, The Netherlands
| | - Carla J. H. van der Kallen
- grid.5012.60000 0001 0481 6099CARIM School for Cardiovascular Diseases, Maastricht University (UM), Maastricht, The Netherlands ,grid.412966.e0000 0004 0480 1382Department of Internal Medicine, Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, P.O. Box 5800, 6202AZ Maastricht, The Netherlands
| | - Marleen M. J. van Greevenbroek
- grid.5012.60000 0001 0481 6099CARIM School for Cardiovascular Diseases, Maastricht University (UM), Maastricht, The Netherlands ,grid.412966.e0000 0004 0480 1382Department of Internal Medicine, Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, P.O. Box 5800, 6202AZ Maastricht, The Netherlands
| | - Anke Wesselius
- grid.5012.60000 0001 0481 6099Department of Complex Genetics and Epidemiology, NUTRIM School for Nutrition and Translational Research in Metabolism, UM, Maastricht, The Netherlands
| | - Casper G. Schalkwijk
- grid.5012.60000 0001 0481 6099CARIM School for Cardiovascular Diseases, Maastricht University (UM), Maastricht, The Netherlands ,grid.412966.e0000 0004 0480 1382Department of Internal Medicine, Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, P.O. Box 5800, 6202AZ Maastricht, The Netherlands
| | - Nicolaas C. Schaper
- grid.5012.60000 0001 0481 6099CARIM School for Cardiovascular Diseases, Maastricht University (UM), Maastricht, The Netherlands ,grid.5012.60000 0001 0481 6099CAPHRI Care and Public Health Research Institute, UM, Maastricht, The Netherlands ,grid.412966.e0000 0004 0480 1382Division of Endocrinology and Metabolic Disease, Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Martijn C. G. J. Brouwers
- grid.5012.60000 0001 0481 6099CARIM School for Cardiovascular Diseases, Maastricht University (UM), Maastricht, The Netherlands ,grid.412966.e0000 0004 0480 1382Division of Endocrinology and Metabolic Disease, Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Coen D. A. Stehouwer
- grid.5012.60000 0001 0481 6099CARIM School for Cardiovascular Diseases, Maastricht University (UM), Maastricht, The Netherlands ,grid.412966.e0000 0004 0480 1382Department of Internal Medicine, Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, P.O. Box 5800, 6202AZ Maastricht, The Netherlands
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29
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Sun C, van Soest J, Koster A, Eussen SJPM, Schram MT, Stehouwer CDA, Dagnelie PC, Dumontier M. Studying the association of diabetes and healthcare cost on distributed data from the Maastricht Study and Statistics Netherlands using a privacy-preserving federated learning infrastructure. J Biomed Inform 2022; 134:104194. [PMID: 36064113 DOI: 10.1016/j.jbi.2022.104194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 08/26/2022] [Accepted: 08/29/2022] [Indexed: 11/28/2022]
Abstract
The mining of personal data collected by multiple organizations remains challenging in the presence of technical barriers, privacy concerns, and legal and/or organizational restrictions. While a number of privacy-preserving and data mining frameworks have recently emerged, much remains to show their practical utility. In this study, we implement and utilize a secure infrastructure using data from Statistics Netherlands and the Maastricht Study to learn the association between Type 2 Diabetes Mellitus (T2DM) and healthcare expenses considering the impact of lifestyle, physical activities, and complications of T2DM. Through experiments using real-world distributed personal data, we present the feasibility and effectiveness of the secure infrastructure for practical use cases of linking and analyzing vertically partitioned data across multiple organizations. We discovered that individuals diagnosed with T2DM had significantly higher expenses than those with prediabetes, while participants with prediabetes spent more than those without T2DM in all the included healthcare categories to different degrees. We further discuss a joint effort from technical, ethical-legal, and domain-specific experts that is highly valued for applying such a secure infrastructure to real-life use cases to protect data privacy.
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Affiliation(s)
- Chang Sun
- Institute of Data Science, Faculty of Science and Engineering, Maastricht University, Maastricht, The Netherlands.
| | - Johan van Soest
- Brightlands Institute of Smart Society, Faculty of Science and Engineering, Maastricht University, Heerlen, The Netherlands
| | - Annemarie Koster
- Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands; Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Simone J P M Eussen
- School for Cardiovascular Diseases, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands; Department of Epidemiology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Miranda T Schram
- School for Cardiovascular Diseases, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands; Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands; School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands; Maastricht Heart & Vascular Center, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Coen D A Stehouwer
- School for Cardiovascular Diseases, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands; Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Pieter C Dagnelie
- School for Cardiovascular Diseases, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands; Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Michel Dumontier
- Institute of Data Science, Faculty of Science and Engineering, Maastricht University, Maastricht, The Netherlands
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30
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DeJong NR, Jansen JFA, van Boxtel MPJ, Schram MT, Stehouwer CDA, Dagnelie PC, van der Kallen CJH, Kroon AA, Wesselius A, Koster A, Backes WH, Köhler S. Cognitive resilience depends on white matter connectivity: The Maastricht Study. Alzheimers Dement 2022; 19:1164-1174. [PMID: 35920350 DOI: 10.1002/alz.12758] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/26/2022] [Accepted: 06/22/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Differences in brain network connectivity may reflect the capability of the neurological substrate to compensate for brain damage and preserve cognitive function (cognitive reserve). We examined the associations between white matter connectivity, brain damage markers, and cognition in a population sample of middle-aged individuals. METHODS A total of 4759 participants from The Maastricht Study (mean age = 59.2, SD = 8.7, 50.2% male) underwent cognitive testing and diffusion magnetic resonance imaging (dMRI), from which brain volume, structural connectivity, and vascular damage were quantified. Multivariable linear regression was used to investigate whether connectivity modified the association between brain damage and cognition, adjusted for demographic and cardiometabolic risk factors. RESULTS More atrophic and vascular brain damage was associated with worse cognition scores. Increasing connectivity moderated the negative association between damage and cognition (χ2 = 8.64, df = 3, p ≤ 0.001); individuals with high damage but strong connectivity showed normal cognition. DISCUSSION Findings support the reserve hypothesis by showing that brain connectivity is associated with cognitive resilience.
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Affiliation(s)
- Nathan R DeJong
- School for Mental Health & Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Alzheimer Centrum Limburg, Maastricht University Medical Center+, Maastricht, The Netherlands.,Department of Radiology & Nuclear Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Jacobus F A Jansen
- School for Mental Health & Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Department of Radiology & Nuclear Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands.,Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Martin P J van Boxtel
- School for Mental Health & Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Alzheimer Centrum Limburg, Maastricht University Medical Center+, Maastricht, The Netherlands.,Department of Radiology & Nuclear Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Miranda T Schram
- School for Mental Health & Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,School for Cardiovascular Diseases (CARIM), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands.,Maastricht Heart & Vascular Center, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Coen D A Stehouwer
- School for Cardiovascular Diseases (CARIM), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Pieter C Dagnelie
- School for Cardiovascular Diseases (CARIM), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Carla J H van der Kallen
- School for Cardiovascular Diseases (CARIM), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Abraham A Kroon
- School for Cardiovascular Diseases (CARIM), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Anke Wesselius
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Annemarie Koster
- Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.,Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Walter H Backes
- School for Mental Health & Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Department of Radiology & Nuclear Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands.,Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Sebastian Köhler
- School for Mental Health & Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Alzheimer Centrum Limburg, Maastricht University Medical Center+, Maastricht, The Netherlands
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31
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Brouwers MCGJ, Simons N, Kooi ME, de Ritter R, van Dongen MCJM, Eussen SJPM, Bekers O, Kooman J, van Greevenbroek MMJ, van der Kallen CJH, Schram MT, Schaper NC, Schalkwijk CG, Stehouwer CDA. Intrahepatic lipid content is independently associated with soluble E-selectin levels: The Maastricht study. Dig Liver Dis 2022; 54:1038-1043. [PMID: 35135742 DOI: 10.1016/j.dld.2022.01.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 12/13/2021] [Accepted: 01/14/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Evidence is accumulating that liver sinusoidal endothelial cells are involved in the pathogenesis of non-alcoholic fatty liver disease. Previous studies have suggested that the endothelial biomarker soluble E-selectin (sE-selectin) is to an important extent liver-derived. AIMS To study the relationship of intrahepatic lipid (IHL) content with sE-selectin at the population level. METHODS This study was conducted in participants of The Maastricht Study (n = 1,634), a population-based cohort study enriched with patients with type 2 diabetes. We assessed the cross-sectional association between IHL content, quantified by MRI, and sE-selectin via multivariable regression with adjustment for age, sex, type 2 diabetes, educational level, BMI, Dutch Healthy Diet index, physical activity, and the Matsuda index. RESULTS Standardized IHL content was associated with (log) sE-selectin (age-, sex- and type 2 diabetes-adjusted regression coefficient [B]: 0.048 [95%CI:0.038;0.058], p<0.001), even after full adjustment (B: 0.030 [0.019;0.042], p<0.001). Such an association was not observed for soluble vascular cell adhesion molecule 1 (sVCAM-1) levels. CONCLUSION IHL content is an independent determinant of sE-selectin at the population level. These findings support further studies to unravel the involvement of liver sinusoidal endothelial cells in the different stages of non-alcoholic fatty liver disease and the specific role of E-selectin herein.
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Affiliation(s)
- Martijn C G J Brouwers
- Department of Internal Medicine, Division of Endocrinology and Metabolic Disease, Maastricht University Medical Centre, Maastricht, the Netherlands; CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands.
| | - Nynke Simons
- Department of Internal Medicine, Division of Endocrinology and Metabolic Disease, Maastricht University Medical Centre, Maastricht, the Netherlands; CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands; Department of Internal Medicine, Division of General Internal Medicine, Laboratory for Metabolism and Vascular Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Marianne Eline Kooi
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands; Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Rianneke de Ritter
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands; Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Martien C J M van Dongen
- Department of Epidemiology, Maastricht University, Maastricht, the Netherlands; CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Simone J P M Eussen
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands; Department of Epidemiology, Maastricht University, Maastricht, the Netherlands
| | - Otto Bekers
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands; Department of Clinical Chemistry, Central Diagnostic Laboratory, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Jeroen Kooman
- Department of Internal Medicine, Division of Nephrology, Maastricht University Medical Centre, Maastricht, the Netherlands; NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | - Marleen M J van Greevenbroek
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands; Department of Internal Medicine, Division of General Internal Medicine, Laboratory for Metabolism and Vascular Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Carla J H van der Kallen
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands; Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Miranda T Schram
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands; Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands; Heart & Vascular Centre, Maastricht University Medical Centre, the Netherlands
| | - Nicolaas C Schaper
- Department of Internal Medicine, Division of Endocrinology and Metabolic Disease, Maastricht University Medical Centre, Maastricht, the Netherlands; CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
| | - Casper G Schalkwijk
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands; Department of Internal Medicine, Division of General Internal Medicine, Laboratory for Metabolism and Vascular Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Coen D A Stehouwer
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands; Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands
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32
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Veugen MGJ, Onete VG, Henry RMA, Brunner-La Rocca HP, Koster A, Dagnelie PC, Schaper NC, Sep SJS, van der Kallen CJH, van Boxtel MPJ, Reesink KD, Schouten JS, Savelberg HHCM, Köhler S, Verhey FR, van den Bergh JPW, Schram MT, Stehouwer CDA. Health burden in type 2 diabetes and prediabetes in The Maastricht Study. Sci Rep 2022; 12:7337. [PMID: 35513556 PMCID: PMC9072328 DOI: 10.1038/s41598-022-11136-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 04/19/2022] [Indexed: 12/02/2022] Open
Abstract
Mortality in type 2 diabetes, is determined not only by classical complications, but also by comorbidities, and is linked to hyperglycaemia and apparent even in prediabetes. We aimed to comprehensively investigate, in a population-based cohort, health burden defined as the presence of comorbidities in addition to classical complications and cardiometabolic risk factors, in not only type 2 diabetes but also prediabetes. Such population-based study has not been performed previously. Extensive phenotyping was performed in 3,410 participants of the population-based Maastricht Study (15.0% prediabetes and 28.6% type 2 diabetes) to assess presence of 17 comorbidities, six classical complications, and ten cardiometabolic risk factors. These were added up into individual and combined sum scores and categorized. Group differences were studied with multinomial regression analyses adjusted for age and sex. Individuals with type 2 diabetes and prediabetes, as compared to normal glucose metabolism (NGM), had greater comorbidities, classical complications, cardiometabolic risk factors and combined sum scores (comorbidities sum score ≥ 3: frequencies (95% CI) 61.5% (57.6;65.4) and 41.2% (36.5;45.9) vs. 25.4% (23.5;27.4), p-trend < 0.001; classical complications ≥ 2 (26.6% (23.1;30.1; P < 0.001 vs. NGM) and 10.1% (7.8;12.7; P = 0.065 vs NGM) vs. 8.0% (6.9;9.3)); cardiometabolic risk factors ≥ 6 (39.7% (35.9;43.4) and 28.5% (24.5;32.6) vs. 14.0% (12.5;15.6); p-trend < 0.001); combined ≥ 8 (66.6% (62.7;70.5) and 48.4% (43.7;53.1) vs. 26.0%(24.1;28.0), p-trend < 0.001). Type 2 diabetes and prediabetes health burden was comparable to respectively 32 and 14 years of ageing. Our population-based study shows, independently of age and sex, a considerable health burden in both type 2 diabetes and prediabetes, which to a substantial extent can be attributed to comorbidities in addition to classical complications and cardiometabolic risk factors. Our findings emphasize the necessity of comorbidities' awareness in (pre)diabetes and for determining the exact role of hyperglycaemia in the occurrence of comorbidities.
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Affiliation(s)
- Marja G J Veugen
- Department of Internal Medicine, Maastricht University Medical Centre +, P. Debyelaan 25, P.O. Box 5800, 6202AZ, Maastricht, The Netherlands.
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands.
| | - Veronica G Onete
- Department of Internal Medicine, Maastricht University Medical Centre +, P. Debyelaan 25, P.O. Box 5800, 6202AZ, Maastricht, The Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
| | - Ronald M A Henry
- Department of Internal Medicine, Maastricht University Medical Centre +, P. Debyelaan 25, P.O. Box 5800, 6202AZ, Maastricht, The Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
- Heart and Vascular Centre, Maastricht University Medical Centre +, Maastricht, The Netherlands
| | - Hans-Peter Brunner-La Rocca
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
- Department of Cardiology, Maastricht University Medical Centre +, Maastricht, the Netherlands
| | - Annemarie Koster
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
- Department of Social Medicine, Maastricht University, Maastricht, The Netherlands
| | - Pieter C Dagnelie
- Department of Internal Medicine, Maastricht University Medical Centre +, P. Debyelaan 25, P.O. Box 5800, 6202AZ, Maastricht, The Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
| | - Nicolaas C Schaper
- Department of Internal Medicine, Maastricht University Medical Centre +, P. Debyelaan 25, P.O. Box 5800, 6202AZ, Maastricht, The Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Simone J S Sep
- Department of Internal Medicine, Maastricht University Medical Centre +, P. Debyelaan 25, P.O. Box 5800, 6202AZ, Maastricht, The Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
- Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands
| | - Carla J H van der Kallen
- Department of Internal Medicine, Maastricht University Medical Centre +, P. Debyelaan 25, P.O. Box 5800, 6202AZ, Maastricht, The Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
| | - Martin P J van Boxtel
- Department of Psychiatry and Neuropsychology and MHeNS School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Koen D Reesink
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
- Department of Biomedical Engineering, Maastricht University Medical Centre +, Maastricht, The Netherlands
| | - Johannes S Schouten
- Department of Ophthalmology, Maastricht University Medical Centre +, Maastricht, The Netherlands
- Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Hans H C M Savelberg
- Department of Human Movement Sciences, Maastricht University, Maastricht, The Netherlands
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology and MHeNS School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Frans R Verhey
- Department of Psychiatry and Neuropsychology and MHeNS School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Joop P W van den Bergh
- Department of Family Medicine, Maastricht University, Maastricht, The Netherlands
- Department of Internal Medicine, Subdivision of Rheumatology, Maastricht University Medical Centre+, Maastricht, The Netherlands
- Department of Internal Medicine, Subdivision of Endocrinology, VieCuri Medical Center, Venlo, The Netherlands
| | - Miranda T Schram
- Department of Internal Medicine, Maastricht University Medical Centre +, P. Debyelaan 25, P.O. Box 5800, 6202AZ, Maastricht, The Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
- Heart and Vascular Centre, Maastricht University Medical Centre +, Maastricht, The Netherlands
| | - Coen D A Stehouwer
- Department of Internal Medicine, Maastricht University Medical Centre +, P. Debyelaan 25, P.O. Box 5800, 6202AZ, Maastricht, The Netherlands.
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands.
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Vandercappellen EJ, Koster A, Savelberg HHCM, Eussen SJPM, Dagnelie PC, Schaper NC, Schram MT, van der Kallen CJH, van Greevenbroek MMJ, Wesselius A, Schalkwijk CG, Kroon AA, Henry RMA, Stehouwer CDA. Sedentary behaviour and physical activity are associated with biomarkers of endothelial dysfunction and low-grade inflammation-relevance for (pre)diabetes: The Maastricht Study. Diabetologia 2022; 65:777-789. [PMID: 35119485 PMCID: PMC8960649 DOI: 10.1007/s00125-022-05651-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 10/28/2021] [Indexed: 12/18/2022]
Abstract
AIMS/HYPOTHESIS Biomarkers of endothelial dysfunction and low-grade inflammation are important in the pathogenesis of CVD and can potentially be modified by physical activity and sedentary behaviour. Effects of physical activity on biomarkers of endothelial dysfunction may be especially prominent in type 2 diabetes. METHODS In the population-based Maastricht Study (n = 2363, 51.5% male, 28.3% type 2 diabetes, 15.1% prediabetes [defined as impaired glucose tolerance and impaired fasting glucose]), we determined biomarkers of endothelial dysfunction and low-grade inflammation, and combined z scores were calculated. Physical activity and sedentary behaviour were measured by activPAL. Linear regression analyses were used with adjustment for demographic, lifestyle and cardiovascular risk factors. RESULTS The association between total, light, moderate-to-vigorous and vigorous intensity physical activity and sedentary time on the one hand and biomarkers of endothelial dysfunction on the other were generally significant and were consistently stronger in prediabetes and type 2 diabetes as compared with normal glucose metabolism status (p for interaction <0.05). Associations between physical activity and sedentary behaviour on the one hand and low-grade inflammation on the other were also significant and were similar in individuals with and without (pre)diabetes (p for interaction >0.05). CONCLUSIONS/INTERPRETATION Physical activity and sedentary behaviour are associated with biomarkers of endothelial dysfunction and low-grade inflammation. For biomarkers of endothelial dysfunction, associations between physical activity and sedentary behaviour were consistently stronger in (pre)diabetes than in normal glucose metabolism. Whether increasing physical activity or decreasing sedentary time can positively influence biomarkers of endothelial dysfunction in individuals with prediabetes and type 2 diabetes requires further study.
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Affiliation(s)
- Evelien J Vandercappellen
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Annemarie Koster
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- Department of Social Medicine, Maastricht University, Maastricht, the Netherlands
| | - Hans H C M Savelberg
- Department of Nutrition and Movement Science, Maastricht University, Maastricht, the Netherlands
- NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | - Simone J P M Eussen
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Epidemiology, Maastricht University, Maastricht, the Netherlands
| | - Pieter C Dagnelie
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
| | - Nicolaas C Schaper
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Miranda T Schram
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- MHeNS School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
- Heart and Vascular Center, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Carla J H van der Kallen
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
| | - Marleen M J van Greevenbroek
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
| | - Anke Wesselius
- NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
- Department of Complex Genetics and Epidemiology, Maastricht University, Maastricht, the Netherlands
| | - Casper G Schalkwijk
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
| | - Abraham A Kroon
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Heart and Vascular Center, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Ronald M A Henry
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Heart and Vascular Center, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Coen D A Stehouwer
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands.
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands.
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34
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Buziau AM, Eussen SJPM, Kooi ME, van der Kallen CJH, van Dongen MCJM, Schaper NC, Henry RMA, Schram MT, Dagnelie PC, van Greevenbroek MMJ, Wesselius A, Bekers O, Meex SJR, Schalkwijk CG, Stehouwer CDA, Brouwers MCGJ. Fructose Intake From Fruit Juice and Sugar-Sweetened Beverages Is Associated With Higher Intrahepatic Lipid Content: The Maastricht Study. Diabetes Care 2022; 45:1116-1123. [PMID: 35158374 DOI: 10.2337/dc21-2123] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 01/01/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Epidemiological evidence regarding the relationship between fructose intake and intrahepatic lipid (IHL) content is inconclusive. We, therefore, assessed the relationship between different sources of fructose and IHL at the population level. RESEARCH DESIGN AND METHODS We used cross-sectional data from The Maastricht Study, a population-based cohort study (n = 3,981; mean ± SD age: 60 ± 9 years; 50% women). We assessed the relationship between fructose intake (assessed with a food-frequency questionnaire)-total and derived from fruit, fruit juice, and sugar-sweetened beverages (SSB)-and IHL (quantified with 3T Dixon MRI) with adjustment for age, sex, type 2 diabetes, education, smoking status, physical activity, and intakes of total energy, alcohol, saturated fat, protein, vitamin E, and dietary fiber. RESULTS Energy-adjusted total fructose intake and energy-adjusted fructose from fruit were not associated with IHL in the fully adjusted models (P = 0.647 and P = 0.767). In contrast, energy-adjusted intake of fructose from fruit juice and SSB was associated with higher IHL in the fully adjusted models (P = 0.019 and P = 0.009). Individuals in the highest tertile of energy-adjusted intake of fructose from fruit juice and SSB had a 1.04-fold (95% CI 0.99; 1.11) and 1.09-fold (95% CI 1.03; 1.16) higher IHL, respectively, in comparison with the lowest tertile in the fully adjusted models. Finally, the association for fructose from fruit juice was stronger in individuals with type 2 diabetes (P for interaction = 0.071). CONCLUSIONS Fructose from fruit juice and SSB is independently associated with higher IHL. These cross-sectional findings contribute to current knowledge in support of measures to reduce the intake of fructose-containing beverages as a means to prevent nonalcoholic fatty liver disease at the population level.
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Affiliation(s)
- Amée M Buziau
- Division of Endocrinology and Metabolic Disease, Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands.,School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, the Netherlands.,Laboratory for Metabolism and Vascular Medicine, Division of General Internal Medicine, Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Simone J P M Eussen
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, the Netherlands.,Department of Epidemiology, Maastricht University, Maastricht, the Netherlands.,Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - M Eline Kooi
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, the Netherlands.,Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Carla J H van der Kallen
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, the Netherlands.,Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Martien C J M van Dongen
- Department of Epidemiology, Maastricht University, Maastricht, the Netherlands.,Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Nicolaas C Schaper
- Division of Endocrinology and Metabolic Disease, Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands.,School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, the Netherlands.,Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Ronald M A Henry
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, the Netherlands.,Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands.,Heart & Vascular Centre, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Miranda T Schram
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, the Netherlands.,Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands.,Heart & Vascular Centre, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Pieter C Dagnelie
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, the Netherlands.,Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Marleen M J van Greevenbroek
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, the Netherlands.,Laboratory for Metabolism and Vascular Medicine, Division of General Internal Medicine, Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Anke Wesselius
- School for Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, the Netherlands.,Department of Complex Genetics and Epidemiology, Maastricht University, Maastricht, the Netherlands
| | - Otto Bekers
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, the Netherlands.,Central Diagnostic Laboratory, Department of Clinical Chemistry, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Steven J R Meex
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, the Netherlands.,Central Diagnostic Laboratory, Department of Clinical Chemistry, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Casper G Schalkwijk
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, the Netherlands.,Laboratory for Metabolism and Vascular Medicine, Division of General Internal Medicine, Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Coen D A Stehouwer
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, the Netherlands.,Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Martijn C G J Brouwers
- Division of Endocrinology and Metabolic Disease, Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands.,School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, the Netherlands
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35
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Beran M, Muzambi R, Geraets A, Albertorio‐Diaz JR, Adriaanse MC, Iversen MM, Kokoszka A, Nefs G, Nouwen A, Pouwer F, Huber JW, Schmitt A, Schram MT. The bidirectional longitudinal association between depressive symptoms and HbA 1c : A systematic review and meta-analysis. Diabet Med 2022; 39:e14671. [PMID: 34407250 PMCID: PMC9292323 DOI: 10.1111/dme.14671] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 06/17/2021] [Accepted: 08/16/2021] [Indexed: 12/11/2022]
Abstract
AIM To investigate whether there is a bidirectional longitudinal association of depression with HbA1c . METHODS We conducted a systematic literature search in PubMed, PsycINFO, CINAHL and EMBASE for observational, longitudinal studies published from January 2000 to September 2020, assessing the association between depression and HbA1c in adults. We assessed study quality with the Newcastle-Ottawa-Scale. Pooled effect estimates were reported as partial correlation coefficients (rp ) or odds ratios (OR). RESULTS We retrieved 1642 studies; 26 studies were included in the systematic review and eleven in the meta-analysis. Most studies (16/26) focused on type 2 diabetes. Study quality was rated as good (n = 19), fair (n = 2) and poor (n = 5). Of the meta-analysed studies, six investigated the longitudinal association between self-reported depressive symptoms and HbA1c and five the reverse longitudinal association, with a combined sample size of n = 48,793 and a mean follow-up of 2 years. Higher levels of baseline depressive symptoms were associated with subsequent higher levels of HbA1c (partial r = 0.07; [95% CI 0.03, 0.12]; I2 38%). Higher baseline HbA1c values were also associated with 18% increased risk of (probable) depression (OR = 1.18; [95% CI 1.12,1.25]; I2 0.0%). CONCLUSIONS Our findings support a bidirectional longitudinal association between depressive symptoms and HbA1c . However, the observed effect sizes were small and future research in large-scale longitudinal studies is needed to confirm this association. Future studies should investigate the role of type of diabetes and depression, diabetes distress and diabetes self-management behaviours. Our results may have clinical implications, as depressive symptoms and HbA1c levels could be targeted concurrently in the prevention and treatment of diabetes and depression. REGISTRATION PROSPERO ID CRD42019147551.
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Affiliation(s)
- Magdalena Beran
- School for Cardiovascular Disease (CARIM)Department of Internal MedicineMaastricht UniversityMaastrichtThe Netherlands
| | - Rutendo Muzambi
- Faculty of Epidemiology and Population HealthLondon School of Hygiene and Tropical MedicineLondonUnited Kingdom
| | - Anouk Geraets
- School for Cardiovascular Disease (CARIM)Department of Internal MedicineMaastricht UniversityMaastrichtThe Netherlands
- Department of Psychiatry and NeuropsychologyMHeNs School for Mental Health and NeuroscienceMaastricht UniversityMaastrichtThe Netherlands
| | | | - Marcel C. Adriaanse
- Department of Health Sciences and Amsterdam Public Health Research InstituteFaculty of ScienceVrije UniversiteitAmsterdamThe Netherlands
| | - Marjolein M. Iversen
- Department of Health and Caring SciencesFaculty of Health and Social SciencesWestern Norway University of Applied SciencesBergenNorway
| | - Andrzej Kokoszka
- II Department of PsychiatryMedical University of WarsawWarszawaPoland
| | - Giesje Nefs
- Department of Medical PsychologyRadboud University Medical CenterRadboud Institute for Health SciencesNijmegenThe Netherlands
- Center of Research on Psychology in Somatic Diseases (CoRPS)Department of Medical and Clinical PsychologyTilburg UniversityTilburgThe Netherlands
- DiabeterNational Treatment and Research Center for Children, Adolescents and Young Adults with Type 1 DiabetesRotterdamThe Netherlands
| | - Arie Nouwen
- Department of PsychologyMiddlesex UniversityLondonUnited Kingdom
- School of Health, Wellbeing and Social CareThe Open UniversityMilton KeynesUnited Kingdom
| | - Frans Pouwer
- Department of PsychologyUniversity of Southern DenmarkOdenseDenmark
- STENO Diabetes CenterOdense University HospitalOdenseDenmark
| | - Jörg W. Huber
- School of Health SciencesUniversity of BrightonBrightonUnited Kingdom
| | - Andreas Schmitt
- German Center for Diabetes Research (DZDMünchen‐NeuherbergGermany
- Research Institute of the Diabetes Academy Mergentheim (FIDAMBad MergentheimGermany
| | - Miranda T. Schram
- School for Cardiovascular Disease (CARIM)Department of Internal MedicineMaastricht UniversityMaastrichtThe Netherlands
- Department of Psychiatry and NeuropsychologyMHeNs School for Mental Health and NeuroscienceMaastricht UniversityMaastrichtThe Netherlands
- Heart and Vascular CentreMaastricht University Medical Center+MaastrichtThe Netherlands
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36
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van Hulten V, Sarodnik C, Driessen JHM, Schaper NC, Geusens PPMM, Webers CAB, Dinant GJ, Ottenheijm RPG, Rasmussen NH, Viggers R, Stehouwer CDA, van der Kallen CJH, Schram MT, Bours SPG, Dagnelie PC, van den Bergh JP. Prevalent Morphometrically Assessed Vertebral Fractures in Individuals With Type 2 Diabetes, Prediabetes and Normal Glucose Metabolism: The Maastricht Study. Front Endocrinol (Lausanne) 2022; 13:832977. [PMID: 35250885 PMCID: PMC8894595 DOI: 10.3389/fendo.2022.832977] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 01/24/2022] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Type 2 diabetes (T2D) is frequently reported to be associated with an increased fracture risk. Epidemiological data on prevalent morphometric vertebral fractures (VFs) in T2D are sparse and even less is known in the prediabetic state. PURPOSE To determine the association between prevalence and severity of morphometric VFs and glucose metabolism state: normal glucose metabolism (NGM), impaired glucose metabolism (prediabetes) or T2D. METHODS This study included cross-sectional data from 3625 participants of the Maastricht Study who had a vertebral fracture assessment on lateral Dual Energy X-Ray Absorptiometry images. VFs were classified based on morphometric assessment into mild, moderate and severe VFs (respectively 20-24%, 25-39% or ≥40% reduction in expected vertebral body height). Logistic regression models were used to investigate the association between glucose metabolism status and the prevalence and severity of VFs. Analyses were adjusted for subject characteristics and life-style factors. RESULTS T2D individuals were older (62.8 ± 7.5 years old) and less often female (30.5%) compared to the NGM group (57.7 ± 8.5 years old, and 58.8% female, respectively). At least one mild, moderate or severe prevalent VF was found in 8.6% of the men and 2.2% of the women in the T2D group, in 9.4% and 8.4% in the prediabetes group and in 9.1% and 4.8% in the NGM group, respectively. After adjustment T2D in women was associated with a lower probability of having a prevalent VF compared to NGM [adjusted OR 0.25 (95% CI 0.09-0.65)], while this was not the case for prediabetes. Furthermore, women with T2D had a significantly lower probability of a prevalent moderate or severe VF [adjusted OR 0.32 (95% CI 0.11-0.96)]. In men there was no significant association between T2D or prediabetes and prevalent VFs. CONCLUSION Women with T2D had a lower probability of prevalent VFs compared to women with a normal glucose metabolism, while this was not the case for men with T2D and participants with prediabetes.
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Affiliation(s)
- Veerle van Hulten
- Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Centre+ (MUMC+), Maastricht, Netherlands
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
| | - Cindy Sarodnik
- Division of Rheumatology, Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), Maastricht, Netherlands
| | - Johanna H. M. Driessen
- Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Centre+ (MUMC+), Maastricht, Netherlands
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
| | - Nicolaas C. Schaper
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), Maastricht, Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Piet P. M. M. Geusens
- Division of Rheumatology, Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), Maastricht, Netherlands
- Biomedical Research Institute, University Hasselt, Hasselt, Belgium
| | - Carol A. B. Webers
- University Eye Clinic Maastricht, Maastricht University Medical Centre+ (MUMC+), Maastricht, Netherlands
| | - Geert-Jan Dinant
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Ramon P. G. Ottenheijm
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Nicklas H. Rasmussen
- Steno Diabetes Center North Jutland, Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark
| | - Rikke Viggers
- Steno Diabetes Center North Jutland, Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Coen D. A. Stehouwer
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), Maastricht, Netherlands
| | - Carla J. H. van der Kallen
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), Maastricht, Netherlands
| | - Miranda T. Schram
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), Maastricht, Netherlands
- Heart and Vascular Center, Maastricht University Medical Center+ (MUMC+), Maastricht, Netherlands
| | - Sandrine P. G. Bours
- Division of Rheumatology, Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), Maastricht, Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Pieter C. Dagnelie
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
- Department of Epidemiology, Maastricht University, Maastricht, Netherlands
| | - Joop P. van den Bergh
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), Maastricht, Netherlands
- Subdivision of Endocrinology, Department of Internal Medicine, VieCuri Medical Center, Venlo, Netherlands
- *Correspondence: Joop P. van den Bergh,
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37
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De Jong N, Backes WH, Jansen JF, van Boxtel MP, Schram MT, Stehouwer CD, Dagnelie PC, van Greevenbroek MM, van der Kallen CJ, Kroon AA, Schaper NC, Eussen SJ, Koster A, Wesselius A, Sep SJ, Koehler S. White matter network structure as a substrate of cognitive brain reserve in cerebral small‐vessel disease: The Maastricht Study. Alzheimers Dement 2021. [DOI: 10.1002/alz.056389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Nathan De Jong
- Maastricht University Maastricht Netherlands
- Maastricht University Medical Center Maastricht Netherlands
- Alzheimer Center Limburg Maastricht Netherlands
| | - Walter H. Backes
- Maastricht University Maastricht Netherlands
- Maastricht University Medical Center Maastricht Netherlands
| | - Jacobus F.A. Jansen
- Maastricht University Maastricht Netherlands
- Maastricht University Medical Center Maastricht Netherlands
- Eindhoven University of Technology Eindhoven Netherlands
| | - Martin P.J. van Boxtel
- Maastricht University Maastricht Netherlands
- Alzheimer Center Limburg Maastricht Netherlands
| | - Miranda T. Schram
- Maastricht University Maastricht Netherlands
- Maastricht University Medical Center Maastricht Netherlands
| | - Coen D.A. Stehouwer
- Maastricht University Maastricht Netherlands
- Maastricht University Medical Center Maastricht Netherlands
| | - Pieter C. Dagnelie
- Maastricht University Maastricht Netherlands
- Maastricht University Medical Center Maastricht Netherlands
| | | | - Carla J.H. van der Kallen
- Maastricht University Maastricht Netherlands
- Maastricht University Medical Center Maastricht Netherlands
| | - Abraham A. Kroon
- Maastricht University Maastricht Netherlands
- Maastricht University Medical Center Maastricht Netherlands
| | - Nicolaas C. Schaper
- Maastricht University Maastricht Netherlands
- Maastricht University Medical Center Maastricht Netherlands
| | | | | | - Anke Wesselius
- Maastricht University Maastricht Netherlands
- Maastricht University Medical Center Maastricht Netherlands
| | - Simone J.S. Sep
- Maastricht University Maastricht Netherlands
- Maastricht University Medical Center Maastricht Netherlands
- Adelante, Center of Expertise in Rehabilitation and Audiology Hoensbroek Netherlands
| | - Sebastian Koehler
- Maastricht University Maastricht Netherlands
- Alzheimer Center Limburg Maastricht Netherlands
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38
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van Dinther M, Schram MT, Jansen JFA, Backes WH, Houben AJHM, Berendschot TTJM, Schalkwijk CG, Stehouwer CDA, van Oostenbrugge RJ, Staals J. Extracerebral microvascular dysfunction is related to brain MRI markers of cerebral small vessel disease: The Maastricht Study. GeroScience 2021; 44:147-157. [PMID: 34816376 PMCID: PMC8811003 DOI: 10.1007/s11357-021-00493-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 11/16/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Cerebral small vessel disease (cSVD) is a late consequence of cerebral microvascular dysfunction (MVD). MVD is hard to measure in the brain due to its limited accessibility. Extracerebral MVD (eMVD) measures can give insights in the etiology of cerebral MVD, as MVD may be a systemic process. We aim to investigate whether a compound score consisting of several eMVD measures is associated with structural cSVD MRI markers. METHODS Cross-sectional data of the population-based Maastricht Study was used (n = 1872, mean age 59 ± 8 years, 49% women). Measures of eMVD included flicker light-induced retinal arteriolar and venular dilation response (retina), albuminuria and glomerular filtration rate (kidney), heat-induced skin hyperemia (skin), and plasma biomarkers of endothelial dysfunction (sICAM-1, sVCAM-1, sE-selectin, and von Willebrand factor). These measures were standardized into z scores and summarized into a compound score. Linear and logistic regression analyses were used to investigate the associations between the compound score and white matter hyperintensity (WMH) volume, and the presence of lacunes and microbleeds, as measured by brain MRI. RESULTS The eMVD compound score was associated with WMH volume independent of age, sex, and cardiovascular risk factors (St β 0.057 [95% CI 0.010-0.081], p value 0.01), but not with the presence of lacunes (OR 1.011 [95% CI 0.803-1.273], p value 0.92) or microbleeds (OR 1.055 [95% CI 0.896-1.242], p value 0.52). CONCLUSION A compound score of eMVD is associated with WMH volume. Further research is needed to expand the knowledge about the role of systemic MVD in the pathophysiology of cSVD.
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Affiliation(s)
- Maud van Dinther
- Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands. .,CARIM - School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands.
| | - Miranda T Schram
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.,MHeNs - School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Jacobus F A Jansen
- MHeNs - School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.,Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Walter H Backes
- CARIM - School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands.,MHeNs - School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.,Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Alfons J H M Houben
- CARIM - School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands.,Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Tos T J M Berendschot
- MHeNs - School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.,Department of Ophthalmology, Maastricht University Medical Center, Maastricht, The Netherlands.,NUTRIM - School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Casper G Schalkwijk
- CARIM - School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands.,Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Coen D A Stehouwer
- CARIM - School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands.,Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Robert J van Oostenbrugge
- Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands.,CARIM - School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands.,MHeNs - School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Julie Staals
- Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands.,CARIM - School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
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Bakker L, Ramakers IHGB, van Boxtel MPJ, Schram MT, Stehouwer CDA, van der Kallen CJH, Dagnelie PC, van Greevenbroek MMJ, Wesselius A, Midttun Ø, Ueland PM, Verhey FRJ, Eussen SJPM, Köhler S. Associations between plasma kynurenines and cognitive function in individuals with normal glucose metabolism, prediabetes and type 2 diabetes: the Maastricht Study. Diabetologia 2021; 64:2445-2457. [PMID: 34409496 PMCID: PMC8494700 DOI: 10.1007/s00125-021-05521-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 04/09/2021] [Indexed: 10/26/2022]
Abstract
AIMS/HYPOTHESIS Studies investigating associations between kynurenines and cognitive function have generally been small, restricted to clinical samples or have found inconsistent results, and associations in the general adult population, and in individuals with type 2 diabetes in particular, are not clear. Therefore, the aim of the present study was to investigate cross-sectional associations between plasma kynurenines and cognitive function in a cohort of middle-aged participants with normal glucose metabolism, prediabetes (defined as impaired fasting glucose and/or impaired glucose tolerance) and type 2 diabetes. METHODS Plasma kynurenines were quantified in 2358 participants aged 61 ± 8 years. Cross-sectional associations of kynurenines with cognitive impairment and cognitive domain scores were investigated using logistic, multiple linear and restricted cubic spline regression analyses adjusted for several confounders. RESULTS Effect modification by glucose metabolism status was found for several associations with cognitive impairment, hence analyses were stratified. In individuals with prediabetes, 3-hydroxykynurenine (OR per SD 0.59 [95% CI 0.37, 0.94]) and 3-hydroxyanthranilic acid (0.67 [0.47, 0.96]) were associated with lower odds of cognitive impairment after full adjustment. In individuals with type 2 diabetes, kynurenine (0.80 [0.66, 0.98]), 3-hydroxykynurenine (0.82 [0.68, 0.99]), kynurenic acid (0.81 [0.68, 0.96]), xanthurenic acid (0.73 [0.61, 0.87]) and 3-hydroxyanthranilic acid (0.73 [0.60, 0.87]) were all associated with lower odds of cognitive impairment. Kynurenic acid (β per SD 0.07 [95% CI 0.02, 0.13]) and xanthurenic acid (0.06 [0.01, 0.11]) were also associated with better executive function/attention. No associations were observed in individuals with normal glucose metabolism. CONCLUSIONS/INTERPRETATION Several kynurenines were cross-sectionally associated with lower odds of cognitive impairment and better cognitive functioning in type 2 diabetes, while less widespread associations were seen in prediabetes. Low levels of kynurenines might be involved in the pathway of type 2 diabetes and cognitive decline but this needs further studies.
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Affiliation(s)
- Lieke Bakker
- MHeNs School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
- Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands
| | - Inez H G B Ramakers
- MHeNs School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
- Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands
| | - Martin P J van Boxtel
- MHeNs School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
- Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands
| | - Miranda T Schram
- MHeNs School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
- Heart and Vascular Center, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Coen D A Stehouwer
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Carla J H van der Kallen
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Pieter C Dagnelie
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Marleen M J van Greevenbroek
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Anke Wesselius
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands
- Department of Complex Genetics and Epidemiology, Maastricht University, Maastricht, the Netherlands
| | | | - Per M Ueland
- University of Bergen, Bergen, Norway
- Haukeland University Hospital, Bergen, Norway
| | - Frans R J Verhey
- MHeNs School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
- Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands
| | - Simone J P M Eussen
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Epidemiology, Maastricht University, Maastricht, the Netherlands
| | - Sebastian Köhler
- MHeNs School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands.
- Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands.
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van Gennip ACE, Stehouwer CDA, van Boxtel MPJ, Verhey FRJ, Koster A, Kroon AA, Köhler S, van Greevenbroek MMJ, Wesselius A, Eussen SJPM, Backes WH, Jansen JF, Schram MT, Henry RMA, Singh-Manoux A, van Sloten TT. Association of Type 2 Diabetes, According to the Number of Risk Factors Within Target Range, With Structural Brain Abnormalities, Cognitive Performance, and Risk of Dementia. Diabetes Care 2021; 44:2493-2502. [PMID: 34588209 PMCID: PMC9612883 DOI: 10.2337/dc21-0149] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 06/15/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Type 2 diabetes is associated with increased risks of cognitive dysfunction and brain abnormalities. The extent to which risk factor modification can mitigate these risks is unclear. We investigated the associations between incident dementia, cognitive performance, and brain abnormalities among individuals with type 2 diabetes, according to the number of risk factors on target, compared with control subjects without diabetes. RESEARCH DESIGN AND METHODS Prospective data were from UK Biobank of 87,856 individuals (n = 10,663 diabetes, n = 77,193 control subjects; baseline 2006-2010), with dementia follow-up until February 2018. Individuals with diabetes were categorized according to the number of seven selected risk factors within the guideline-recommended target range (nonsmoking; guideline-recommended levels of glycated hemoglobin, blood pressure, BMI, albuminuria, physical activity, and diet). Outcomes were incident dementia, domain-specific cognitive performance, white matter hyperintensities, and total brain volume. RESULTS After a mean follow-up of 9.0 years, 147 individuals (1.4%) with diabetes and 412 control subjects (0.5%) had incident dementia. Among individuals with diabetes, excess dementia risk decreased stepwise for a higher number of risk factors on target. Compared with control subjects (incidence rate per 1,000 person-years 0.62 [95% CI 0.56; 0.68]), individuals with diabetes who had five to seven risk factors on target had no significant excess dementia risk (absolute rate difference per 1,000 person-years 0.20 [-0.11; 0.52]; hazard ratio 1.32 [0.89; 1.95]). Similarly, differences in processing speed, executive function, and brain volumes were progressively smaller for a higher number of risk factors on target. These results were replicated in the Maastricht Study. CONCLUSIONS Among individuals with diabetes, excess dementia risk, lower cognitive performance, and brain abnormalities decreased stepwise for a higher number of risk factors on target.
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Affiliation(s)
- April C E van Gennip
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands.,School for Cardiovascular Diseases CARIM, Maastricht University, Maastricht, the Netherlands
| | - Coen D A Stehouwer
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands.,School for Cardiovascular Diseases CARIM, Maastricht University, Maastricht, the Netherlands
| | - Martin P J van Boxtel
- School for Mental Health and Neuroscience MHENS, Maastricht University, Maastricht, the Netherlands.,Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Frans R J Verhey
- School for Mental Health and Neuroscience MHENS, Maastricht University, Maastricht, the Netherlands.,Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Annemarie Koster
- Care and Public Health Research Institute CAPHRI, Maastricht University, Maastricht, the Netherlands.,Department of Social Medicine, Maastricht University, Maastricht, the Netherlands
| | - Abraham A Kroon
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands.,School for Cardiovascular Diseases CARIM, Maastricht University, Maastricht, the Netherlands
| | - Sebastian Köhler
- School for Mental Health and Neuroscience MHENS, Maastricht University, Maastricht, the Netherlands.,Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Marleen M J van Greevenbroek
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands.,School for Cardiovascular Diseases CARIM, Maastricht University, Maastricht, the Netherlands
| | - Anke Wesselius
- School of Nutrition and Translational Research in Metabolism NUTRIM, Maastricht University, Maastricht, the Netherlands.,Department of Genetics and Cell Biology, Complex Genetics, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Simone J P M Eussen
- School for Cardiovascular Diseases CARIM, Maastricht University, Maastricht, the Netherlands.,Department of Epidemiology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Walter H Backes
- School for Mental Health and Neuroscience MHENS, Maastricht University, Maastricht, the Netherlands.,Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Jacobus F Jansen
- School for Mental Health and Neuroscience MHENS, Maastricht University, Maastricht, the Netherlands.,Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands.,Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Miranda T Schram
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands.,School for Cardiovascular Diseases CARIM, Maastricht University, Maastricht, the Netherlands.,School for Mental Health and Neuroscience MHENS, Maastricht University, Maastricht, the Netherlands.,Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Ronald M A Henry
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands.,School for Cardiovascular Diseases CARIM, Maastricht University, Maastricht, the Netherlands
| | - Archana Singh-Manoux
- Epidemiology of Ageing and Neurodegenerative Diseases, Université de Paris, INSERM U1153, Paris, France.,Department of Epidemiology and Public Health, University College London, London, U.K
| | - Thomas T van Sloten
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands .,School for Cardiovascular Diseases CARIM, Maastricht University, Maastricht, the Netherlands
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Strikwerda M, Beulens JW, Remmelzwaal S, Schoonmade LJ, van Straten A, Schram MT, Elders PJ, Rutters F. The Association of Burnout and Vital Exhaustion With Type 2 Diabetes: A Systematic Review and Meta-Analysis. Psychosom Med 2021; 83:1013-1030. [PMID: 34334726 DOI: 10.1097/psy.0000000000000995] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This study aimed to investigate the association of burnout and vital exhaustion with measures of glycemic control and type 2 diabetes (T2D) in a systematic review and meta-analysis. METHODS PubMed, Embase, and PsycINFO were searched from inception to April 2, 2020. Data extraction and quality assessment were performed using the Effective Public Health Practice Project tool. When possible, results were meta-analyzed using random-effects models and rated using the Grading of Recommendations, Assessment, Development and Evaluation. RESULTS A total of 5317 titles/abstracts were screened, 140 articles were read full text, of which 29 studies were included. Eighteen studies were cross-sectional, three prospective and eight were case-control studies. Burnout and vital exhaustion were significantly associated with T2D, with a pooled odds ratio of 1.8 (95% confidence interval [CI] = 1.4 to 2.4, I2 = 79%; 9 studies). Glycated hemoglobin A1c levels were not significantly higher in people with burnout and vital exhaustion, compared to those without, with a pooled standardized mean difference of 0.35 (95% CI = -0.62 to 1.33, I2 = 98%; 7 studies). In addition, no differences in glucose levels were observed (standardized mean difference = 0.02, 95% CI = -0.26 to 0.30, I2 = 90%; 9 studies). Sensitivity analyses showed no decrease in heterogeneity when excluding studies with low quality (I2glucose = 89%) or studies with a study n < 40 population (I2T2D = 77%). The level of Grading of Recommendations, Assessment, Development and Evaluation evidence was moderate to low quality because of 18 studies having a cross-sectional design. CONCLUSIONS Burnout and vital exhaustion might be associated with a higher risk of T2D, but not with glycemic control. Methodological shortcomings and high heterogeneity of the studies included complicate the interpretation of our results.
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Affiliation(s)
- Marije Strikwerda
- From the Amsterdam UMC, location VUmc, Department of Epidemiology and Data Science (Strikwerda, Beulens, Remmelzwaal, Rutters), Amsterdam Public Health Research Institute (Strikweda, Beulens, Remmelzwaal, Elders); Julius Centre for Health Sciences and Primary Care (Beulens), University Medical Centre Utrecht, Utrecht; the University Library (Schoonmade), VU, Amsterdam; Faculty of Behavioural and Movement Sciences and Amsterdam Public Health Research Institute (van Straten), Vrije Universiteit, HV Amsterdam; Department of Internal Medicine, Cardiovascular Research Institute Maastricht (CARIM), MHeNS School for Mental Health and Neuroscience (Schram), Maastricht University Medical Center+, Maastricht; and Amsterdam UMC, location VUmc, Department of General Practice (Elders), Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
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42
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van der Heide FCT, Steens ILM, Geraets AFJ, Foreman YD, Henry RMA, Kroon AA, van der Kallen CJH, van Sloten TT, Dagnelie PC, van Dongen MCJM, Eussen SJPM, Berendschot TTJM, Schouten JSAG, Webers CAB, van Greevenbroek MMJ, Wesselius A, Koster A, Schaper NC, Schram MT, Köhler S, Stehouwer CDA. Association of Retinal Nerve Fiber Layer Thickness, an Index of Neurodegeneration, With Depressive Symptoms Over Time. JAMA Netw Open 2021; 4:e2134753. [PMID: 34783825 PMCID: PMC8596200 DOI: 10.1001/jamanetworkopen.2021.34753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
IMPORTANCE Whether neurodegeneration contributes to the early pathobiology of late-life depression remains incompletely understood. OBJECTIVE To investigate whether lower retinal nerve fiber layer (RNFL) thickness, a marker of neurodegeneration, is associated with the incidence of clinically relevant depressive symptoms and depressive symptoms over time. DESIGN, SETTING, AND PARTICIPANTS This is a population-based cohort study from the Netherlands (The Maastricht Study) with baseline examination between 2010 and 2020 and median (IQR) follow-up of 5.0 (3.0-6.0) years. Participants were recruited from the general population. Individuals with type 2 diabetes were oversampled by design. Data analysis was performed from September 2020 to January 2021. EXPOSURES RNFL, an index of neurodegeneration, assessed with optical coherence tomography. MAIN OUTCOMES AND MEASURES Depressive symptoms were assessed with the Patient Health Questionnaire (PHQ)-9 (continuous score, 0-27) at baseline and over time via annual assessments. The presence of clinically relevant depressive symptoms was defined as a PHQ-9 score of 10 or higher. RESULTS We used data from 4934 participants with depressive symptoms over time (mean [SD] age, 59.7 [8.4] years; 2159 women [50.8%]; 870 had type 2 diabetes [20.5%]). Lower RNFL thickness was associated with higher incidence of clinically relevant depressive symptoms (per 1 SD, hazard ratio 1.11; 95% CI, 1.01-1.23) and more depressive symptoms over time (per 1 SD, rate ratio, 1.04; 95% CI, 1.01-1.06), after adjustment for demographic, cardiovascular, and lifestyle factors. CONCLUSIONS AND RELEVANCE The findings of this study suggest that lower RNFL thickness is associated with higher incidence of clinically relevant depressive symptoms and more depressive symptoms over time. Hence, neurodegeneration may be associated with the early pathobiology of late-life depression.
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Affiliation(s)
- Frank C. T. van der Heide
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, the Netherlands
| | - Indra L. M. Steens
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, the Netherlands
| | - Anouk F. J. Geraets
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, the Netherlands
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center+, Maastricht, the Netherlands
- School of Mental Health and Neuroscience, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Yuri D. Foreman
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, the Netherlands
| | - Ronald M. A. Henry
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, the Netherlands
- Heart and Vascular Center, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Abraham A. Kroon
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, the Netherlands
| | - Carla J. H. van der Kallen
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, the Netherlands
| | - Thomas T. van Sloten
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, the Netherlands
| | - Pieter C. Dagnelie
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, the Netherlands
| | - Martien C. J. M. van Dongen
- Care and Public Health Research Institute, Maastricht University, the Netherlands
- Department of Epidemiology, Maastricht University, the Netherlands
| | - Simone J. P. M. Eussen
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Epidemiology, Maastricht University, the Netherlands
| | - Tos T. J. M. Berendschot
- University Eye Clinic Maastricht, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Jan S. A. G. Schouten
- Department of Ophthalmology, Canisius-Wilhelmina Ziekenhuis Nijmegen, the Netherlands
| | - Carroll A. B. Webers
- University Eye Clinic Maastricht, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Marleen M. J. van Greevenbroek
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, the Netherlands
| | - Anke Wesselius
- Department of Complex Genetics and Epidemiology, School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | - Annemarie Koster
- Care and Public Health Research Institute, Maastricht University, the Netherlands
| | - Nicolaas C. Schaper
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, the Netherlands
| | - Miranda T. Schram
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, the Netherlands
- School of Mental Health and Neuroscience, Maastricht University Medical Center+, Maastricht, the Netherlands
- Heart and Vascular Center, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Seb Köhler
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center+, Maastricht, the Netherlands
- School of Mental Health and Neuroscience, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Coen D. A. Stehouwer
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, the Netherlands
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Gianfredi V, Beran M, Koster A, Eussen SJ, Odone A, Signorelli C, Schaper NC, Köhler S, Bosma H, Dagnelie PC, Stehouwer CDA, Wesselius A, Amerio A, Brinkhues S, Dukers-Muijrers N, Schram MT. Association between social network characteristics and prevalent and incident depression: The Maastricht Study. J Affect Disord 2021; 293:338-346. [PMID: 34229287 DOI: 10.1016/j.jad.2021.06.046] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 05/09/2021] [Accepted: 06/19/2021] [Indexed: 11/30/2022]
Abstract
AIMS Social network characteristics may provide a novel non-pharmaceutical target for the prevention of depression. We investigated the temporal association of a broad range of structural and functional social network characteristics with incident depressive symptoms over 5 years of follow-up. METHODS We used data from The Maastricht Study, a population-based prospective cohort study (n=2,465, mean age 59.8±8.1 years, 49.1% women, 11,585 person-years of follow-up). Social network characteristics were assessed through a name generator questionnaire. Clinically relevant depressive symptoms (9-item Patient Health Questionnaire score≥10) were assessed at baseline and annually. We used multivariable logistic and Cox regression analyses, adjusted for sociodemographic, lifestyle and cardiovascular risk factors. RESULTS In cross-sectional analyses less emotional support for discomfort and with important decisions, and less informational support were associated with prevalent depressive symptoms (OR[95%CI] 1.19 [1.01-1.40]; 1.22 [1.05-1.43], and 1.20 [1.04-1.39], respectively). Every fewer 10% of family members was associated with prevalent depressive symptoms (1.11 [1.01-1.23]). In longitudinal analyses, less emotional support on important decisions was also associated with higher risk of incident depressive symptoms (HR[95%CI] 1.13 [1.03-1.25]). In addition, every fewer 10% of the network that was a family member was associated with a higher hazard of incident depressive symptoms (1.07 [1.01-1.13]). CONCLUSIONS This study shows that less emotional support and fewer family members in the network were associated with higher risk of both prevalent and incident depression. The importance of emotional support and the role that family plays should be considered in treatment and prevention of depression.
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Affiliation(s)
- Vincenza Gianfredi
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Magdalena Beran
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands; Department of Internal Medicine, Maastricht University, Maastricht, the Netherlands
| | - Annemarie Koster
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; Department of Social Medicine, Maastricht University, Maastricht, the Netherlands
| | - Simone Jpm Eussen
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands; Department of Epidemiology; Maastricht University, Maastricht, the Netherlands
| | - Anna Odone
- Department Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Carlo Signorelli
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Nicolaas C Schaper
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands; Department of Internal Medicine, Maastricht University, Maastricht, the Netherlands
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands; MHeNS School for Mental Health and Neuroscience, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Hans Bosma
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; Department of Social Medicine, Maastricht University, Maastricht, the Netherlands
| | - Pieter C Dagnelie
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands; Department of Epidemiology; Maastricht University, Maastricht, the Netherlands
| | - Coen DA Stehouwer
- Department of Internal Medicine, Maastricht University, Maastricht, the Netherlands; Department of Social Medicine, Maastricht University, Maastricht, the Netherlands
| | - Anke Wesselius
- NUTRIM School for Nutrition and Translational Research in Metabolism, University of Maastricht, Department of Complex Genetics, Maastricht University, Maastricht, the Netherlands
| | - Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Mood Disorders Program, Tufts Medical Center, Boston, MA, USA
| | - Stephanie Brinkhues
- Department of Sexual Health, Infectious Diseases, and Environmental Health, Heerlen, South Limburg Public Health Service, the Netherlands
| | - Nicole Dukers-Muijrers
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; NUTRIM School for Nutrition and Translational Research in Metabolism, University of Maastricht, Department of Complex Genetics, Maastricht University, Maastricht, the Netherlands; Department of Sexual Health, Infectious Diseases, and Environmental Health, Heerlen, South Limburg Public Health Service, the Netherlands; Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Miranda T Schram
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands; Department of Internal Medicine, Maastricht University, Maastricht, the Netherlands; MHeNS School for Mental Health and Neuroscience, Maastricht University Medical Center+, Maastricht, the Netherlands; Heart and Vascular Center, Maastricht University Medical Center+, Maastricht, the Netherlands.
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Janssen EPCJ, Köhler S, Geraets AFJ, Stehouwer CDA, Schaper NC, Sep SJS, Henry RMA, van der Kallen CJH, Schalkwijk CG, Koster A, Verhey FR, Schram MT. Low-grade inflammation and endothelial dysfunction predict four-year risk and course of depressive symptoms: The Maastricht study. Brain Behav Immun 2021; 97:61-67. [PMID: 34186200 DOI: 10.1016/j.bbi.2021.06.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 05/19/2021] [Accepted: 06/19/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Low-grade inflammation (LGI) and endothelial dysfunction (ED) might play a key role in the development of depression. We investigated the associations and mediation of LGI and ED with four-year incidence and course of depressive symptoms (remitted, recurrent or persistent). DESIGN, SETTING, PARTICIPANTS, MEASUREMENTS In this prospective cohort study (mean age 59.6 ± 8.2 years, 48.9% women, 26.6% diabetes by design), Cox and multinomial regression analyses, adjusted for age, sex, educational level and diabetes status were used to investigate the associations of LGI and ED with onset and course of depressive symptoms as assessed by the PHQ-9 questionnaire. RESULTS During 10,847 person-years of follow-up, 264 participants developed incident depression. Higher levels of LGI (OR [95%CI] per SD 1.32[1.16-1.49], p < 0.001) and ED (1.26[1.11-1.43], p < 0.001) were associated with incident depressive symptoms. In mediation analysis, 60% of the total effect of ED with incident depressive symptoms could be attributed to LGI. 76 out of 2637 participants had a persistent course of depressive symptoms. Higher levels of LGI (1.75[1.40-2.19], p < 0.001) and ED (1.33[1.04-1.71], p = 0.021) were associated with a persistent course of depressive symptoms. Higher ED was more strongly associated with persistent depressive symptoms (1.33[1.04-1.71], p = 0.021), while LGI was associated with remission of depression symptoms. CONCLUSIONS LGI and ED were both associated with incident depressive symptoms, where the latter association was substantially mediated by LGI. ED was further associated with a persistent course of depressive symptoms, while LGI was not. These results suggest a temporal, vascular contribution of both LGI and ED to the etiology and chronicity of depressive symptoms.
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Affiliation(s)
- Eveline P C J Janssen
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center+, Maastricht, the Netherlands; Mondriaan Department of Old Age Psychiatry, Heerlen, the Netherlands.
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center+, Maastricht, the Netherlands; MHeNs School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Anouk F J Geraets
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center+, Maastricht, the Netherlands; MHeNs School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands; Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands; CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands
| | - Coen D A Stehouwer
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands; CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands
| | - Nicolaas C Schaper
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands; CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands; CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands
| | - Simone J S Sep
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands; CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands; Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, the Netherlands
| | - Ronald M A Henry
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands; CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands
| | - Carla J H van der Kallen
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands; CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands
| | - Casper G Schalkwijk
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands; CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands
| | - Annemarie Koster
- CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands; Department of Social Medicine, Maastricht University, Maastricht, the Netherlands
| | - Frans R Verhey
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center+, Maastricht, the Netherlands; MHeNs School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Miranda T Schram
- MHeNs School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands; Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands; CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands; Heart and Vascular Center, Maastricht University Medical Center+, Maastricht, the Netherlands.
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Heger IS, Deckers K, Schram MT, Stehouwer CDA, Dagnelie PC, van der Kallen CJH, Koster A, Eussen SJPM, Jansen JFA, Verhey FRJ, van Boxtel MPJ, Köhler S. Associations of the Lifestyle for Brain Health Index With Structural Brain Changes and Cognition: Results From the Maastricht Study. Neurology 2021; 97:e1300-e1312. [PMID: 34433680 PMCID: PMC8480401 DOI: 10.1212/wnl.0000000000012572] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 07/01/2021] [Indexed: 11/15/2022] Open
Abstract
Background and Objectives Observational research has shown that a substantial proportion of all dementia cases worldwide are attributable to modifiable risk factors. Dementia risk scores might be useful to identify high-risk individuals and monitor treatment adherence. The objective of this study was to investigate whether a dementia risk score, the Lifestyle for Brain Health (LIBRA) index, is associated with MRI markers and cognitive functioning/impairment in the general population. Methods Cross-sectional data were used from the observational population-based cohort of The Maastricht Study. The weighted compound score of LIBRA (including 12 dementia risk and protective factors, e.g., hypertension, physical inactivity) was calculated, with higher scores indicating higher dementia risk. Standardized volumes of white matter, gray matter, and CSF (as proxy for general brain atrophy), white matter hyperintensities, and presence of cerebral small vessel disease were derived from 3T MRI. Cognitive functioning was tested in 3 domains: memory, information processing speed, and executive function and attention. Values ≤1.5 SDs below the average were defined as cognitive impairment. Multiple regression analyses and structural equation modeling were used, adjusted for age, sex, education, intracranial volume, and type 2 diabetes. Results Participants (n = 4,164; mean age 59 years; 49.7% men) with higher LIBRA scores (mean 1.19, range −2.7 to 9.2), denoting higher dementia risk, had higher volumes of white matter hyperintensities (β = 0.051, p = 0.002) and lower scores on information processing speed (β = −0.067, p = 0.001) and executive function and attention (β = −0.065, p = 0.004). Only in men, associations between LIBRA score and volumes of gray matter (β = −0.093, p < 0.001) and CSF (β = 0.104, p < 0.001) and memory (β = −0.054, p = 0.026) were found. White matter hyperintensities and CSF volume partly mediated the association between LIBRA score and cognition. Discussion Higher health- and lifestyle-based dementia risk is associated with markers of general brain atrophy, cerebrovascular pathology, and worse cognition, suggesting that LIBRA meaningfully summarizes individual lifestyle-related brain health. Improving LIBRA factors on an individual level might improve population brain health. Sex differences in lifestyle-related pathology and cognition need to be further explored. Classification of Evidence This study provides Class II evidence that higher LIBRA scores are significantly associated with lower scores in some cognitive domains and a higher risk of cognitive impairment.
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Affiliation(s)
- Irene S Heger
- From the School for Mental Health and Neuroscience (I.S.H., K.D., M.T.S., J.F.A.J., F.R.J.V., M.P.J.v.B., S.K.), Department of Psychiatry and Neuropsychology (I.S.H., K.D., F.R.J.V., M.P.J.v.B., S.K.), School for Cardiovascular Diseases (M.T.S., C.D.A.S., P.C.D., C.J.H.v.d.K., S.J.P.M.E.), Care and Public Health Research Institute (A.K.), Department of Social Medicine (A.K.), and Department of Epidemiology (S.J.P.M.E.), Maastricht University; and Heart and Vascular Center (M.T.S.), Department of Internal Medicine (M.T.S., C.D.A.S., P.C.D., C.J.H.v.d.K.), and Department of Radiology (J.F.A.J.), Maastricht University Medical Center+, the Netherlands.
| | - Kay Deckers
- From the School for Mental Health and Neuroscience (I.S.H., K.D., M.T.S., J.F.A.J., F.R.J.V., M.P.J.v.B., S.K.), Department of Psychiatry and Neuropsychology (I.S.H., K.D., F.R.J.V., M.P.J.v.B., S.K.), School for Cardiovascular Diseases (M.T.S., C.D.A.S., P.C.D., C.J.H.v.d.K., S.J.P.M.E.), Care and Public Health Research Institute (A.K.), Department of Social Medicine (A.K.), and Department of Epidemiology (S.J.P.M.E.), Maastricht University; and Heart and Vascular Center (M.T.S.), Department of Internal Medicine (M.T.S., C.D.A.S., P.C.D., C.J.H.v.d.K.), and Department of Radiology (J.F.A.J.), Maastricht University Medical Center+, the Netherlands
| | - Miranda T Schram
- From the School for Mental Health and Neuroscience (I.S.H., K.D., M.T.S., J.F.A.J., F.R.J.V., M.P.J.v.B., S.K.), Department of Psychiatry and Neuropsychology (I.S.H., K.D., F.R.J.V., M.P.J.v.B., S.K.), School for Cardiovascular Diseases (M.T.S., C.D.A.S., P.C.D., C.J.H.v.d.K., S.J.P.M.E.), Care and Public Health Research Institute (A.K.), Department of Social Medicine (A.K.), and Department of Epidemiology (S.J.P.M.E.), Maastricht University; and Heart and Vascular Center (M.T.S.), Department of Internal Medicine (M.T.S., C.D.A.S., P.C.D., C.J.H.v.d.K.), and Department of Radiology (J.F.A.J.), Maastricht University Medical Center+, the Netherlands
| | - Coen D A Stehouwer
- From the School for Mental Health and Neuroscience (I.S.H., K.D., M.T.S., J.F.A.J., F.R.J.V., M.P.J.v.B., S.K.), Department of Psychiatry and Neuropsychology (I.S.H., K.D., F.R.J.V., M.P.J.v.B., S.K.), School for Cardiovascular Diseases (M.T.S., C.D.A.S., P.C.D., C.J.H.v.d.K., S.J.P.M.E.), Care and Public Health Research Institute (A.K.), Department of Social Medicine (A.K.), and Department of Epidemiology (S.J.P.M.E.), Maastricht University; and Heart and Vascular Center (M.T.S.), Department of Internal Medicine (M.T.S., C.D.A.S., P.C.D., C.J.H.v.d.K.), and Department of Radiology (J.F.A.J.), Maastricht University Medical Center+, the Netherlands
| | - Pieter C Dagnelie
- From the School for Mental Health and Neuroscience (I.S.H., K.D., M.T.S., J.F.A.J., F.R.J.V., M.P.J.v.B., S.K.), Department of Psychiatry and Neuropsychology (I.S.H., K.D., F.R.J.V., M.P.J.v.B., S.K.), School for Cardiovascular Diseases (M.T.S., C.D.A.S., P.C.D., C.J.H.v.d.K., S.J.P.M.E.), Care and Public Health Research Institute (A.K.), Department of Social Medicine (A.K.), and Department of Epidemiology (S.J.P.M.E.), Maastricht University; and Heart and Vascular Center (M.T.S.), Department of Internal Medicine (M.T.S., C.D.A.S., P.C.D., C.J.H.v.d.K.), and Department of Radiology (J.F.A.J.), Maastricht University Medical Center+, the Netherlands
| | - Carla J H van der Kallen
- From the School for Mental Health and Neuroscience (I.S.H., K.D., M.T.S., J.F.A.J., F.R.J.V., M.P.J.v.B., S.K.), Department of Psychiatry and Neuropsychology (I.S.H., K.D., F.R.J.V., M.P.J.v.B., S.K.), School for Cardiovascular Diseases (M.T.S., C.D.A.S., P.C.D., C.J.H.v.d.K., S.J.P.M.E.), Care and Public Health Research Institute (A.K.), Department of Social Medicine (A.K.), and Department of Epidemiology (S.J.P.M.E.), Maastricht University; and Heart and Vascular Center (M.T.S.), Department of Internal Medicine (M.T.S., C.D.A.S., P.C.D., C.J.H.v.d.K.), and Department of Radiology (J.F.A.J.), Maastricht University Medical Center+, the Netherlands
| | - Annemarie Koster
- From the School for Mental Health and Neuroscience (I.S.H., K.D., M.T.S., J.F.A.J., F.R.J.V., M.P.J.v.B., S.K.), Department of Psychiatry and Neuropsychology (I.S.H., K.D., F.R.J.V., M.P.J.v.B., S.K.), School for Cardiovascular Diseases (M.T.S., C.D.A.S., P.C.D., C.J.H.v.d.K., S.J.P.M.E.), Care and Public Health Research Institute (A.K.), Department of Social Medicine (A.K.), and Department of Epidemiology (S.J.P.M.E.), Maastricht University; and Heart and Vascular Center (M.T.S.), Department of Internal Medicine (M.T.S., C.D.A.S., P.C.D., C.J.H.v.d.K.), and Department of Radiology (J.F.A.J.), Maastricht University Medical Center+, the Netherlands
| | - Simone J P M Eussen
- From the School for Mental Health and Neuroscience (I.S.H., K.D., M.T.S., J.F.A.J., F.R.J.V., M.P.J.v.B., S.K.), Department of Psychiatry and Neuropsychology (I.S.H., K.D., F.R.J.V., M.P.J.v.B., S.K.), School for Cardiovascular Diseases (M.T.S., C.D.A.S., P.C.D., C.J.H.v.d.K., S.J.P.M.E.), Care and Public Health Research Institute (A.K.), Department of Social Medicine (A.K.), and Department of Epidemiology (S.J.P.M.E.), Maastricht University; and Heart and Vascular Center (M.T.S.), Department of Internal Medicine (M.T.S., C.D.A.S., P.C.D., C.J.H.v.d.K.), and Department of Radiology (J.F.A.J.), Maastricht University Medical Center+, the Netherlands
| | - Jacobus F A Jansen
- From the School for Mental Health and Neuroscience (I.S.H., K.D., M.T.S., J.F.A.J., F.R.J.V., M.P.J.v.B., S.K.), Department of Psychiatry and Neuropsychology (I.S.H., K.D., F.R.J.V., M.P.J.v.B., S.K.), School for Cardiovascular Diseases (M.T.S., C.D.A.S., P.C.D., C.J.H.v.d.K., S.J.P.M.E.), Care and Public Health Research Institute (A.K.), Department of Social Medicine (A.K.), and Department of Epidemiology (S.J.P.M.E.), Maastricht University; and Heart and Vascular Center (M.T.S.), Department of Internal Medicine (M.T.S., C.D.A.S., P.C.D., C.J.H.v.d.K.), and Department of Radiology (J.F.A.J.), Maastricht University Medical Center+, the Netherlands
| | - Frans R J Verhey
- From the School for Mental Health and Neuroscience (I.S.H., K.D., M.T.S., J.F.A.J., F.R.J.V., M.P.J.v.B., S.K.), Department of Psychiatry and Neuropsychology (I.S.H., K.D., F.R.J.V., M.P.J.v.B., S.K.), School for Cardiovascular Diseases (M.T.S., C.D.A.S., P.C.D., C.J.H.v.d.K., S.J.P.M.E.), Care and Public Health Research Institute (A.K.), Department of Social Medicine (A.K.), and Department of Epidemiology (S.J.P.M.E.), Maastricht University; and Heart and Vascular Center (M.T.S.), Department of Internal Medicine (M.T.S., C.D.A.S., P.C.D., C.J.H.v.d.K.), and Department of Radiology (J.F.A.J.), Maastricht University Medical Center+, the Netherlands
| | - Martin P J van Boxtel
- From the School for Mental Health and Neuroscience (I.S.H., K.D., M.T.S., J.F.A.J., F.R.J.V., M.P.J.v.B., S.K.), Department of Psychiatry and Neuropsychology (I.S.H., K.D., F.R.J.V., M.P.J.v.B., S.K.), School for Cardiovascular Diseases (M.T.S., C.D.A.S., P.C.D., C.J.H.v.d.K., S.J.P.M.E.), Care and Public Health Research Institute (A.K.), Department of Social Medicine (A.K.), and Department of Epidemiology (S.J.P.M.E.), Maastricht University; and Heart and Vascular Center (M.T.S.), Department of Internal Medicine (M.T.S., C.D.A.S., P.C.D., C.J.H.v.d.K.), and Department of Radiology (J.F.A.J.), Maastricht University Medical Center+, the Netherlands
| | - Sebastian Köhler
- From the School for Mental Health and Neuroscience (I.S.H., K.D., M.T.S., J.F.A.J., F.R.J.V., M.P.J.v.B., S.K.), Department of Psychiatry and Neuropsychology (I.S.H., K.D., F.R.J.V., M.P.J.v.B., S.K.), School for Cardiovascular Diseases (M.T.S., C.D.A.S., P.C.D., C.J.H.v.d.K., S.J.P.M.E.), Care and Public Health Research Institute (A.K.), Department of Social Medicine (A.K.), and Department of Epidemiology (S.J.P.M.E.), Maastricht University; and Heart and Vascular Center (M.T.S.), Department of Internal Medicine (M.T.S., C.D.A.S., P.C.D., C.J.H.v.d.K.), and Department of Radiology (J.F.A.J.), Maastricht University Medical Center+, the Netherlands
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Linkens AMA, Houben AJHM, Kroon AA, Schram MT, Berendschot TTJM, Webers CAB, van Greevenbroek M, Henry RMA, de Galan B, Stehouwer CDA, Eussen SJMP, Schalkwijk CG. Habitual intake of dietary advanced glycation end products is not associated with generalized microvascular function-the Maastricht Study. Am J Clin Nutr 2021; 115:444-455. [PMID: 34581759 PMCID: PMC8827096 DOI: 10.1093/ajcn/nqab302] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 08/24/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Endogenously formed advanced glycation end products (AGEs) may be important drivers of microvascular dysfunction and the microvascular complications of diabetes. AGEs are also formed in food products, especially during preparation methods involving dry heat. OBJECTIVES We aimed to assess cross-sectional associations between dietary AGE intake and generalized microvascular function in a population-based cohort. METHODS In 3144 participants of the Maastricht Study (mean ± SD age: 60 ± 8 y, 51% men) the dietary AGEs Nε-(carboxymethyl)lysine (CML), Nε-(1-carboxyethyl)lysine (CEL), and Nδ-(5-hydro-5-methyl-4-imidazolon-2-yl)-ornithine (MG-H1) were estimated using the combination of our ultra-performance LC-tandem MS dietary AGE database and an FFQ. Microvascular function was determined in the retina as flicker light-induced arteriolar and venular dilation and as central retinal arteriolar and venular equivalents, in plasma as a z score of endothelial dysfunction biomarkers (soluble vascular adhesion molecule 1 and soluble intracellular adhesion molecule 1, soluble E-selectin, and von Willebrand factor), in skin as the heat-induced skin hyperemic response, and in urine as 24-h albuminuria. Associations were evaluated using multiple linear regression adjusting for demographic, cardiovascular, lifestyle, and dietary factors. RESULTS Overall, intakes of CML, CEL, and MG-H1 were not associated with the microvascular outcomes. Although higher intake of CEL was associated with higher flicker light-induced venular dilation (β percentage change over baseline: 0.14; 95% CI: 0.02, 0.26) and lower plasma biomarker z score (β: -0.04 SD; 95% CI: -0.08, -0.00 SD), the effect sizes were small and their biological relevance can be questioned. CONCLUSIONS We did not show any strong association between habitual intake of dietary AGEs and generalized microvascular function. The contribution of dietary AGEs to generalized microvascular function should be further assessed in randomized controlled trials using specifically designed dietary interventions.
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Affiliation(s)
- Armand M A Linkens
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, Netherlands,CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, Netherlands
| | - Alfons J H M Houben
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, Netherlands,CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, Netherlands
| | - Abraham A Kroon
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, Netherlands,CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, Netherlands
| | - Miranda T Schram
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, Netherlands,CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, Netherlands
| | - Tos T J M Berendschot
- University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, Netherlands
| | - Carroll A B Webers
- University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, Netherlands
| | - Marleen van Greevenbroek
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, Netherlands,CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, Netherlands
| | - Ronald M A Henry
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, Netherlands,CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, Netherlands,Heart and Vascular Center, Maastricht University Medical Center, Maastricht, Netherlands
| | - Bastiaan de Galan
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, Netherlands,CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, Netherlands
| | - Coen D A Stehouwer
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, Netherlands,CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, Netherlands
| | - Simone J M P Eussen
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, Netherlands,Department of Epidemiology, Maastricht University, Maastricht, Netherlands,CAPHRI School for Care and Public Health Research Unit, Maastricht University, Maastricht, Netherlands
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De Clerck EEB, Schouten JSAG, Berendschot TTJM, Goezinne F, Liesenborghs I, Dagnelie PC, Schaper NC, Kroon AA, Henry RMA, Reesink KD, Schram MT, Stehouwer CDA, Webers CAB. Vascular risk factors for optical coherence tomography-detected macular cysts: The Maastricht Study. Acta Ophthalmol 2021; 99:e860-e868. [PMID: 33258290 DOI: 10.1111/aos.14677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 10/20/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE To investigate whether higher blood pressure and greater arterial stiffness are associated with the presence of macular cysts and whether this association is already present in the absence of micro-aneurysms in individuals with and without type 2 diabetes. METHODS Using spectral domain optical coherence tomography (OCT), we performed a macular volume scan in 2647 individuals (mean age 60 ± 8 years, 50% men, 27% type 2 diabetes). The association between macular cysts and 24-hour systolic and diastolic blood pressure, pulse pressure, mean arterial blood pressure, carotid-femoral pulse wave velocity and carotid distensibility was assessed by use of logistic regression. RESULTS Twenty-four hours systolic blood pressure was associated with the presence of macular cysts [OR = 1.03 (95% CI 1.00-1.05) per 1 mmHg, p = 0.03]. 24 hr pulse pressure [OR = 1.61 (95% CI 1.11-2.34) per 10 mmHg, p = 0.01] and carotid-femoral pulse wave velocity [OR = 1.16 (95% CI 1.02-1.32) per 1 m/s, p = 0.02] were associated with macular cysts, while carotid distensibility was not [OR = 1.03 (95% CI 0.96-1.11) per 1.0*10-3 /kPa, p = 0.45]. Associations were similar in individuals with and without type 2 diabetes and were already present in the absence of micro-aneurysms. CONCLUSION Twenty-four hours systolic blood pressure, 24 hr pulse pressure and carotid-femoral pulse wave velocity are associated with the presence of OCT-detected macular cysts in individuals with and without type 2 diabetes, even in the absence of micro-aneurysms. Therefore, blood pressure and aortic stiffness are potential factors contributing to macular cysts.
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Affiliation(s)
- Eline E. B. De Clerck
- University Eye Clinic Maastricht Maastricht University Medical Center+ Maastricht The Netherlands
| | - Jan S. A. G. Schouten
- University Eye Clinic Maastricht Maastricht University Medical Center+ Maastricht The Netherlands
| | - Tos T. J. M. Berendschot
- University Eye Clinic Maastricht Maastricht University Medical Center+ Maastricht The Netherlands
| | - Fleur Goezinne
- University Eye Clinic Maastricht Maastricht University Medical Center+ Maastricht The Netherlands
| | - Ilona Liesenborghs
- University Eye Clinic Maastricht Maastricht University Medical Center+ Maastricht The Netherlands
| | - Pieter C. Dagnelie
- Cardiovascular Research Institute Maastricht (CARIM) Maastricht University Medical Center+ Maastricht The Netherlands
- Department of Epidemiology Maastricht University Maastricht The Netherlands
- School for Public Health and Primary Care (CAPHRI) Maastricht University Maastricht The Netherlands
| | - Nicolaas C. Schaper
- Cardiovascular Research Institute Maastricht (CARIM) Maastricht University Medical Center+ Maastricht The Netherlands
- Department of Epidemiology Maastricht University Maastricht The Netherlands
- Department of Internal Medicine Maastricht University Medical Center+ Maastricht The Netherlands
| | - Abraham A. Kroon
- Cardiovascular Research Institute Maastricht (CARIM) Maastricht University Medical Center+ Maastricht The Netherlands
- Department of Internal Medicine Maastricht University Medical Center+ Maastricht The Netherlands
| | - Ronald M. A. Henry
- Department of Internal Medicine Maastricht University Medical Center+ Maastricht The Netherlands
| | - Koen D. Reesink
- Department of Biomedical Engineering Maastricht University Medical Center+ Maastricht The Netherlands
| | - Miranda T. Schram
- Cardiovascular Research Institute Maastricht (CARIM) Maastricht University Medical Center+ Maastricht The Netherlands
- Department of Internal Medicine Maastricht University Medical Center+ Maastricht The Netherlands
- Heart and Vascular Center Maastricht University Medical Center+ Maastricht The Netherlands
| | - Coen D. A. Stehouwer
- Cardiovascular Research Institute Maastricht (CARIM) Maastricht University Medical Center+ Maastricht The Netherlands
- Department of Internal Medicine Maastricht University Medical Center+ Maastricht The Netherlands
| | - Carroll A. B. Webers
- University Eye Clinic Maastricht Maastricht University Medical Center+ Maastricht The Netherlands
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Geraets AF, Köhler S, Jansen JF, Eussen SJ, Stehouwer CDA, Schaper NC, Wesselius A, Verhey FR, Schram MT. The association of markers of cerebral small vessel disease and brain atrophy with incidence and course of depressive symptoms - the maastricht study. J Affect Disord 2021; 292:439-447. [PMID: 34144369 DOI: 10.1016/j.jad.2021.05.096] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 04/29/2021] [Accepted: 05/30/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Cerebral small vessel disease (CSVD) and neurodegeneration may be involved in the development and persistence of late-life depressive symptoms, but longitudinal evidence is scarce. We investigated the longitudinal associations of markers of CSVD and brain atrophy with incident depressive symptoms and the course of depressive symptoms, above and below 60 years of age. METHODS White matter hyperintensity volumes (WMH), presence of lacunar infarcts and cerebral microbleeds, and white matter, grey matter, and cerebral spinal fluid volumes were assessed at baseline by 3T MRI in The Maastricht Study (mean age 59.5±8.5 years, 49.6% women, n=4,347; 16,535 person-years of follow-up). Clinically relevant depressive symptoms (9-item Patient Health Questionnaire≥10) were assessed at baseline and annually over seven years. We used Cox regression and multinomial logistic regression analyses adjusted for demographic, cardiovascular, and lifestyle risk factors. RESULTS Above 60 years of age, larger WMH volumes were associated with an increased risk for incident depressive symptoms (HR[95%CI]:1.24[1.04;1.48] per SD) and a persistent course of depressive symptoms (OR:1.44[1.04;2.00] per SD). Total CSVD burden was associated with persistent depressive symptoms irrespective of age (adjusted OR:1.58[1.03;2.43]), while no associations were found for general markers of brain atrophy. LIMITATIONSS Our findings need replication in other large-scale population-based studies. CONCLUSIONS Our findings may suggest a temporal association of larger WMH volume with the incidence and persistence of late-life depression in the general population and may provide a potential target for the prevention of chronic late-life depression.
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Affiliation(s)
- Anouk Fj Geraets
- Department of Psychiatry and Neuropsychology; Alzheimer Centrum Limburg, the Netherlands; Department of Internal Medicine; School for Mental Health and Neuroscience; School for Cardiovascular Diseases (CARIM)
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology; Alzheimer Centrum Limburg, the Netherlands; School for Mental Health and Neuroscience
| | - Jacobus Fa Jansen
- Department of Radiology and Nuclear Medicine; School for Mental Health and Neuroscience
| | - Simone Jpm Eussen
- Department of Epidemiology; School for Cardiovascular Diseases (CARIM)
| | - Coen DA Stehouwer
- Department of Internal Medicine; School for Cardiovascular Diseases (CARIM)
| | - Nicolaas C Schaper
- Department of Internal Medicine; School for Cardiovascular Diseases (CARIM)
| | - Anke Wesselius
- Department of Genetics & Cell Biology, Complex Genetics, Maastricht University Medical Center (MUMC+), 6202 AZ, Maastricht, Limburg, the Netherlands; School of Nutrition and Translational Research in Metabolism (NUTRIM), Faculty of Health, Medicine & Life Sciences, Maastricht University, 6200 MD, Maastricht, Limburg, the Netherlands
| | - Frans Rj Verhey
- Department of Psychiatry and Neuropsychology; Alzheimer Centrum Limburg, the Netherlands; School for Mental Health and Neuroscience
| | - Miranda T Schram
- Department of Psychiatry and Neuropsychology; Department of Internal Medicine; School for Mental Health and Neuroscience; School for Cardiovascular Diseases (CARIM).
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Abstract
It has been known for decades that social networks are causally related to disease and mortality risk. However, this field of research and its potential for implementation into diabetes care is still in its infancy. In this narrative review, we aim to address the state-of-the-art of social network research in type 2 diabetes prevention and care. Despite the diverse nature and heterogeneity of social network assessments, we can draw valuable lessons from the available studies. First, the structural network variable 'living alone' and the functional network variable 'lack of social support' have been associated with increased type 2 diabetes risk. The latter association may be modified by lifestyle risk factors, such as obesity, low level of physical activity and unhealthy diet. Second, smaller network size and less social support is associated with increased risk of diabetes complications, particularly chronic kidney disease and CHD. Third, current evidence shows a beneficial impact of social support on diabetes self-management. In addition, social support interventions were found to have a small, favourable effect on HbA1c values in the short-term. However, harmonisation and more detailed assessment of social network measurements are needed to utilise social network characteristics for more effective prevention and disease management in type 2 diabetes.
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Affiliation(s)
- Miranda T Schram
- Department of Internal Medicine, Heart and Vascular Center, Maastricht University Medical Center+, School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, the Netherlands.
| | - Willem J J Assendelft
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Theo G van Tilburg
- Department of Sociology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Nicole H T M Dukers-Muijrers
- Department of Sexual Health, Infectious Diseases and Environmental Health, Public Health Service South Limburg, Heerlen, the Netherlands
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
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Foreman YD, van Doorn WPTM, Schaper NC, van Greevenbroek MMJ, van der Kallen CJH, Henry RMA, Koster A, Eussen SJPM, Wesselius A, Reesink KD, Schram MT, Dagnelie PC, Kroon AA, Brouwers MCGJ, Stehouwer CDA. Greater daily glucose variability and lower time in range assessed with continuous glucose monitoring are associated with greater aortic stiffness: The Maastricht Study. Diabetologia 2021; 64:1880-1892. [PMID: 33991193 PMCID: PMC8245390 DOI: 10.1007/s00125-021-05474-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 03/11/2021] [Indexed: 11/04/2022]
Abstract
AIMS CVD is the main cause of morbidity and mortality in individuals with diabetes. It is currently unclear whether daily glucose variability contributes to CVD. Therefore, we investigated whether glucose variability is associated with arterial measures that are considered important in CVD pathogenesis. METHODS We included participants of The Maastricht Study, an observational population-based cohort, who underwent at least 48 h of continuous glucose monitoring (CGM) (n = 853; age: 59.9 ± 8.6 years; 49% women, 23% type 2 diabetes). We studied the cross-sectional associations of two glucose variability indices (CGM-assessed SD [SDCGM] and CGM-assessed CV [CVCGM]) and time in range (TIRCGM) with carotid-femoral pulse wave velocity (cf-PWV), carotid distensibility coefficient, carotid intima-media thickness, ankle-brachial index and circumferential wall stress via multiple linear regression. RESULTS Higher SDCGM was associated with higher cf-PWV after adjusting for demographics, cardiovascular risk factors and lifestyle factors (regression coefficient [B] per 1 mmol/l SDCGM [and corresponding 95% CI]: 0.413 m/s [0.147, 0.679], p = 0.002). In the model additionally adjusted for CGM-assessed mean sensor glucose (MSGCGM), SDCGM and MSGCGM contributed similarly to cf-PWV (respective standardised regression coefficients [st.βs] and 95% CIs of 0.065 [-0.018, 0.167], p = 0.160; and 0.059 [-0.043, 0.164], p = 0.272). In the fully adjusted models, both higher CVCGM (B [95% CI] per 10% CVCGM: 0.303 m/s [0.046, 0.559], p = 0.021) and lower TIRCGM (B [95% CI] per 10% TIRCGM: -0.145 m/s [-0.252, -0.038] p = 0.008) were statistically significantly associated with higher cf-PWV. Such consistent associations were not observed for the other arterial measures. CONCLUSIONS Our findings show that greater daily glucose variability and lower TIRCGM are associated with greater aortic stiffness (cf-PWV) but not with other arterial measures. If corroborated in prospective studies, these results support the development of therapeutic agents that target both daily glucose variability and TIRCGM to prevent CVD.
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Grants
- Pearl String Initiative Diabetes (Amsterdam, the Netherlands)
- Stichting De Weijerhorst (Maastricht, the Netherlands)
- European Regional Development Fund via OP-Zuid
- Health Foundation Limburg (Maastricht, the Netherlands)
- CAPHRI Care and Public Health Research Institute (Maastricht, the Netherlands)
- Stichting Annadal (Maastricht, the Netherlands)
- Province of Limburg
- Dutch Ministry of Economic Affairs
- CARIM School for Cardiovascular Diseases (Maastricht, the Netherlands
- unrestricted grants from Janssen-Cilag B.V. (Tilburg, the Netherlands), Novo Nordisk Farma B.V. (Alphen aan den Rijn, the Netherlands), Sanofi-Aventis Netherlands B.V. (Gouda, the Netherlands), and Medtronic (Tolochenaz, Switzerland)
- NUTRIM School for Nutrition and Translational Research in Metabolism (Maastricht, the Netherlands)
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Affiliation(s)
- Yuri D Foreman
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - William P T M van Doorn
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Clinical Chemistry, Central Diagnostic Laboratory, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Nicolaas C Schaper
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Internal Medicine, Division of Endocrinology and Metabolic Disease, Maastricht University Medical Centre+, Maastricht, the Netherlands
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Marleen M J van Greevenbroek
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Carla J H van der Kallen
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Ronald M A Henry
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, the Netherlands
- Heart and Vascular Center, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Annemarie Koster
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- Department of Social Medicine, Maastricht University, Maastricht, the Netherlands
| | - Simone J P M Eussen
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Epidemiology, Maastricht University, Maastricht, the Netherlands
| | - Anke Wesselius
- NUTRIM School for Nutrition and Translational Research in Metabolism, Department of Complex Genetics and Epidemiology, Maastricht University, Maastricht, the Netherlands
| | - Koen D Reesink
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Heart and Vascular Center, Maastricht University Medical Centre+, Maastricht, the Netherlands
- Department of Biomedical Engineering, Maastricht University, Maastricht, the Netherlands
| | - Miranda T Schram
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, the Netherlands
- Heart and Vascular Center, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Pieter C Dagnelie
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Abraham A Kroon
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, the Netherlands
- Heart and Vascular Center, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Martijn C G J Brouwers
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
- Department of Internal Medicine, Division of Endocrinology and Metabolic Disease, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Coen D A Stehouwer
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands.
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, the Netherlands.
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